Fine needle aspiration (FNA) [fine needle aspiration Cytology (FNAC)] technique was first introduced by Greig and Grey. 1 Since the 1960's, it has been used extensively as a diagnostic tool for rapid evaluation of mainly superficial lesions, especially of lymph nodes. It is cost effective, relatively less traumatic, and enables the pathologist to provide the clinician with a diagnosis in a very short time, and hence is ideal especially for OP patients. 2 Lymphadenopathy is a commonly encountered clinical entity. The diagnosis of the cause underlying the enlarged lymph node(s) enables the clinician to plan appropriate management for each patient. Enlarged superficial lymph nodes are easily amenable to evaluation by FNA technique and hence FNAC forms an important diagnostic tool in the armamentarium of the pathologist. 3 While histopathological evaluation of surgically excised lymph nodes is a more specific and accurate diagnostic parameter, it is relatively more costly, time consuming and discomfiting to the patient, and may not be warranted in every patient. FNAC is more cost effective and relatively non-invasive. 4 FNAC evaluation may prevent a patient having to undergo unnecessary surgery and permit the treating clinician to offer conservative therapy instead.
Background: The Bethesda system of reporting thyroid cytopathology is a standardised system, improving communication between cytopathologists and clinicians, leading to more consistent management approaches. The aim of the research work was to study the utility of Bethesda system in reporting thyroid cytology with histopathological correlation of all the cases undergoing surgical resection.Methods: We studied all the thyroid cytology cases received between November 2012 to April 2014, and classified them according to the Bethesda system. Histopathological correlation was done for all the cases which underwent surgical resection with evaluation of cyto-histological discrepancies.Results: Out of 484 cases studied, 432(89.2%) were benign lesions, 20(4.1%) were malignant,18 (3.7%) were Unsatisfactory/Nondiagnostic, 10(2%) were Follicular neoplasm/Suspicious for neoplasm, 3 (0.6%) were suspicious for malignancy, and 1(0.002%) case was reported as Atypia of undetermined significance. Out of the 54 cases available for histopathological follow-up, cyto-histological discrepancies were noted in 5 cases (9.2%). Statistical analysis of the present study showed that cytological analysis of thyroid lesions by Bethesda system has got high sensitivity (72.72%), high specificity (95.3%) with a positive predictive value of 80% and negative predictive value of 93.1% and a high accuracy (90.7%).Conclusions: Reviewing the thyroid FNAs (fine needle aspirates) using Bethesda system allowed a more specific cytological diagnosis with better interlaboratory agreement. As evidenced by its high sensitivity and specificity, Bethesda system has proven to be a very effective guide for the clinical management of thyroid nodules.
Background: The aim of the study was to identify the pattern of pathologies involving ovarian mass lesions which were received for histopathological evaluation at a tertiary hospital in Hyderabad, Telangana, India during the period January 2012 to December 2016.Methods: The data pertaining to samples of ovarian lesions received for histopathological evaluation at the laboratory of a tertiary care hospital in Hyderabad from January 2012 to December 2016, were analyzed to determine the pattern of pathologies diagnosed during such evaluation and the age distribution of all lesions.Results: Non-neoplastic lesions of the ovary constituted 44.0% of all cases received; follicular cysts constituted 45.5% of these lesions. Malignant lesions constituted only 2.0% of all pathologies. Serous cystadenoma of the ovary constituted the predominant neoplastic lesion diagnosed (62.5% of all neoplastic lesions). 53.2% of patients whose samples were received belonged to the age group of 20-39 years. 90.8% of the lesions were unilateralConclusions: The majority of ovarian lesions received for evaluation were benign and unilateral. Most patients were in the third to sixth decades of life.
Scan to discover onlineBackground & Objective: Metaplastic carcinoma is a diverse variant of invasive breast carcinomas (IBC) characterized by dedifferentiation of malignant cells towards squamous and/or mesenchymal elements. It accounts for 0.3-1.2% of all IBC. These tumors are typically triple-negative by hormonal profiling with a high proliferation index and a dismal prognosis. Lymph node metastasis is an unusual feature in metaplastic carcinoma.
Methods:The present study analyses 30 cases (26 cases of modified radical mastectomy and 4 cases of lumpectomy) of metaplastic carcinoma over 2018-2020 (3 years).Four oncopathologists reviewed routine histopathologic and immunohistochemical-stained slides. The clinical details were collected from the Medical Records Department of the Cancer Institute.Results: A total of 20 (66.67%) cases were patients >50 years of age, 21(70%) out of which were diagnosed as invasive carcinoma, grade 3 according to the Nottingham histological score. Five (16.7%) cases presented with lymph node metastasis. While immunohistochemically 28 (93.3%) cases were triple-negativeCK5/6, P63, EGFR, and Ki-67 (more than 40%) positivity was noted in 25 (83.3%) , 26 (86,7%) , 20 (66.7%), and 25 (83.3%) cases, respectively.
Conclusion:Metaplastic carcinoma is characteristically triple-negative breast malignancies (TNBC) exhibiting a high Ki-67 index and a lower rate of lymph node metastasis. CK5/6, p63, and EGFR are pertinent immunohistochemical markers that may aid in diagnosis. However, those markers are non-specific for the disease and morphologic features are always the key to diagnosis of the process.
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