Comparative Study of Cytology and Histopathology of Cervical Lesion in VIA Positive Patients and Its Correlation with High Risk Human Papilloma Virus.

Cervical cancer is the second most frequent type of cancer and leading cause of mortality among women worldwide. The present study was undertaken to assess precancerous and cancerous cervical lesion by cytology as well as HPV DNA identification and their comparison with histopathology in VIA positive cases. This descriptive, cross-sectional type of observational study was carried out in the Department of Pathology, Mymensingh Medical College in collaboration with the Department of Gynecology and Obstetrics, Mymensingh Medical College Hospital and Department of Microbiology and Hygiene in Bangladesh Agriculture University for HPV DNA detection from July 2012 to June 2013. Study was carried out among 160 VIA positive patients and selected by non-random judgment sampling from the colposcopy clinic. Out of 160 cases, only 40(25.00%) were found HPV DNA positive, while the rest 120(75.00%) cases were negative. Among positive cases 77.50% were cancerous cases and 22.50% were precancerous cases. It was further revealed that in cancerous cases, 86.11% were HPV DNA positive. PCR showed low sensitivity, probably due to sampling error and inclusion of all cases (chronic cervicitis, precancerous and cancerous lesion). The statistical value of accuracy, sensitivity and specificity of Pap smear cytology, HPV DNA test and histopathology yielded some important directives. The sensitivity values of Pap smear cytology and HPV DNA were found 87.50% and 88.89% respectively. Thus Pap smear test showed almost equal sensitivity to DNA test. The accuracy of the Pap smears and HPV DNA in this study was 88.13% and 96.88% respectively. The accuracy of Pap smears is lower than HPV DNA tests. The present study show significant relationship between cytological with HPV DNA test and histopathological diagnosis. But cytology and HPV DNA testing are not suitable as a single test. In conclusion, it can be stated that combination cytology (Pap smear), histopathology and new technologies such as HPV DNA typing would ultimately be more useful.

A Retrospective Histopathological Study on Extra-pulmonary Tuberculosis in Mymensingh.

Tuberculosis is a very common disease in our country. This retrospective histopathological study was designed to assess the distribution of extra-pulmonary tuberculosis (EPTB) in various organs through examination of biopsy specimens. A total of 216 specimens were diagnosed as tubercular lesion by histopathological evaluation in the Department of pathology, Community Based Medical College and a private laboratory during the period from January 2014 to December 2014. Mean age of the case was 32 years. Majority of the cases were female (126 out of 216). Lymph nodes were the most common site of EPTB (62.96%) followed by skin and subcutaneous tissue (17.59%), intestine (11.11%), breast (2.77%), female genital tract (2.31%), male genital tract (1.38%), bone and joint (1.85%). Out of 136 cases of tubercular lymphadenitis, 96(70.58%) were cervical, 18(13.23%) were axillary, 12(3.82%) were mesenteric and 10(7.35%) were inguinal. This study reveals, in our locality, EPTB is very common in adulthood with female preponderance. Cervical lymph node is very common sites for EPTB.

Endometrial stromal nodule - a case report.

Among the endometrial tumour endometrial stromal nodule are very rare. It is one of the form of endometrial stromal tumour. There are no definite presurgical diagnosis and diagnosis in most instances by microscopy. Hysterectomy is the treatment of choice to evaluate the tumour margin to differentiate it from stromal sarcoma. We present a case of 40 years woman, ultrasonographically diagnosed as leiomyoma and ovarian cystadenoma, underwent a total abdominal hysterectomy with one sided salpingo-oophorectomy. Microscopic examination show an endometrial stromal nodule and serous cystadenoma of the ovary. Though it is a benign tumour margin should be carefully examined to differentiate from stromal sarcoma, whose treatment and prognosis is totally different.

Nasal glioma in a six month old girl.

Congenital midline frontonasal swellings are rare condition and nasal glioma accounts for 5% of these abnormality. Nasal gliomas are benign tumours results from embryonic developmental error. Although it is a rare tumour but clinically it has some differential diagnoses. Most common are dermoid tumour, nasal glioma and nasal encephalocele. About 15-20% cases nasal glioma have a fibrous stalk that connecting to the central nervous system. Multidisciplinary approach is needed for proper diagnosis and to prevent life threatening intracranial complication. We present a case of nasal glioma in a 6 months old girl presented with a congenital swelling on the left lateral side of the nose with complaints of watering from the eye of same side.

Comparison between fine needle aspiration cytology with histopathology to validate accurate diagnosis of palpable breast lump.

A prospective study of 114 patients was conducted to assess the clinical correlation and diagnostic accuracy between FNAC and histopathology of breast lumps. Correlation was found out between clinical suspicion with FNAC and histopathological findings. The results obtained from histopathology were matched with those of FNAC and a correlation was sought based on statistical tests. Statistical analysis was performed on data and sensitivity and specificity with positive and negative predictive value were obtained. Although FNAC was performed on 114 patients presented with breast lump but histopathology available for 75 cases. Fifteen cases were found to be malignant on both FNAC and histopathology. For malignant lesion the sensitivity of the study was 96% and the specificity for malignant lesions was 100%. The positive predictive value was 100% and the negative predictive value was 95.12%. It was concluded that FNAC is a cheap, rapid, reliable and accurate test of diagnosing a palpable breast lump. It provides a good histological correlation, thus avoiding undue surgical biopsy prior to definitive surgery for malignancy.

Invasive ductal carcinoma in a young male breast.

Carcinoma arising in the male breast is a rare occurrence. The risk of male breast cancer increases with age, and the median age of diagnosis for men is 10 years later than that for females (67 to 71 years). Because of the absence of lobules in the normal male breast, lobular carcinoma cases are seen infrequently. All of the microscopic types identified in the female breast have been encountered in male but the most frequent is invasive ductal carcinoma and less frequent is invasive lobular carcinoma. We present the case of a 20 years old man presenting with a left breast lump. After left mastectomy with level 2 axillary clearance, histopathological examination revealed infiltrating ductal carcinoma. Our case represents ductal carcinoma in a proven genotypic young male patient showing no exogenous or endogenous estrogens exposure.

Minor criteria for atopic dermatitis in children.

Atopic dermatitis (AD) is a common pruritic, eczematous skin disorder that runs a chronic and relapsing course. Major and minor criteria exist as guideline for arriving at a diagnosis of AD. Minor features vary with ethnicity and genetic background and can be used to aid diagnosis. A descriptive study was conducted including 210 patients of 1-12 years age who had concurrent or past history of AD according to criteria of Hanifin and Rajka. This study was conducted in the department of Dermatology of three different Hospitals of Bangladesh. Out of 33 sub-criteria of Hanifin and Rajka, 20 of which were examined encompassed tendency towards cutaneous infection, environmental factor, high IgE level, intolerance of wool, xerosis, infra-orbital fold, ichthyosis, early age of onset, itch on sweating, palmer hyperlinearity, food hypersensitivity, keratosis pilaris, pityriasis alba, facial erythema, cheilitis, hand eczema, foot eczema, intolerance of lipid solvent, scalp scaling and infra-auricular fissure. Out of 20 examined minor criteria, most common was cutaneous infection in 168(80.0%) patients followed by coursed influenced by environmental factor in 140(66.7%), high IgE level in 126(60.0%), intolerance of wool in 105(50.0%), xerosis in 92(43.8%), infra-orbital fold in 83(39.5%), ichthyosis in 72(34.3%), early age of onset in 65(31.0%), itch on sweating in 56(26.7%), palmary hyperlinearity in 52(24.8%), food hypersensitivity in 40(19.0%), keratosis pilaris in 31(14.8%), pityriasis alba in 30(14.3%), facial erythema in 25(1.9%), cheilitis in 22(10.5%), hand eczema in 19(9.0%), foot eczema in 16(7.6%), intolerance of lipid solvent in 14(6.7% ), scalp scaling in 11(5.2%) and infra-auricular fissure in 10(4.8%). These features were present singly or in combination. The result evidenced that minor criteria are many a times important for the diagnosis where major criteria are uncertain.