To identify the subtypes of atypia of undetermined significance (AUS) that confers a different magnitude for the risk of malignancy (RM), thyroid fine-needle aspiration (FNA) cases carrying a diagnosis of "atypical follicular cells" or "follicular lesion" with surgical pathology followup were included in this study. The direct smears of the aspirates were rereviewed and subclassified into four subgroups based on cytomorphology: AUS cannot exclude follicular neoplasm (AUS-FN), AUS cannot exclude Hürthle cell neoplasm (AUS-HCN), AUS cannot exclude papillary carcinoma (AUS-PTC) and AUS, not otherwise specified (AUS-NOS). Based on the followup histopathologic findings, RM not including papillary microcarcinoma (PMC), RM including PMC and the risk of neoplasm (RN) were calculated for each of the four AUS subgroups. A total of 138 AUS cases were subclassified into AUS-NOS (48), AUS-PTC (41), AUS-FN (32), and AUS-HCN (17). RM not including PMC was 32% for AUS-PTC (P < 0.001), 25% for AUS-FN, 8% for AUS-NOS, 0% for AUS-HCN, and 18% for all AUS cases. RM including PMC was 54% for AUS-PTC (P < 0.001), 34% for AUS-FN, 19% for AUS-NOS, 18% for AUS-HCN, and 33% for all AUS cases. RN was 63% for AUS-PTC (P = 0.05), 81% for AUS-FN (P < 0.01), AUS-HCN 53%, AUS-NOS 44% and 59% for all cases. In our study, subclassification enabled us to further divide AUS cases into high- and low-risk groups. The high-risk group includes AUS-PTC with a significantly higher risk of malignancy and AUS-FN with a significantly higher risks of neoplasm. AUS-HCN and AUS-NOS subgroups demonstrate a lower risk of malignancy of <10%.

No abstract

No abstract

No abstract

IN this article some recent investigations connected with typhoid and para-typhoid infections are reviewed. They merit attention because of their practical applicability to clinical medicine and in that they provide improvements in clinical laboratory methods. The diagnosis of typhoid or para-typhoid infections rests on the recovery of the specific microorganism from the blood, urine, or faeces, or on the demonstration of specific protective substances in the blood-serum. The recovery of the infecting bacillus is the most satisfactory method of diagnosis and it is fortunate that recent research has provided more efficient means to this end. In the earliest stages of the disease cultivation of the blood is by far the most useful procedure. If the bacilli are present in the bloodstream in large numbers their recovery presents no great difficulty. The inoculation of

No abstract

Introduction/Objective Pentalogy of Cantrell is an uncommon congenital disorder characterized by sternal, diaphragmatic, pericardial, intracardiac and supraumbilical abdominal or chest wall defects. It is usually associated with other abnormalities and thus poses a therapeutic challenge, with a high mortality rate despite early diagnosis. Methods/Case Report This is an autopsy case of a 1 day old, former 37-week-old male infant with a prenatal diagnosis of incomplete pentalogy of Cantrell including omphalocele, ectopia cordis, pleural effusions, cardiac anomalies and polyhydramnios who was delivered via elective cesarean section. Maternal history included tobacco use during pregnancy, multiple psychiatric disorders, and a family history of an unbalanced translocation. The infant required intubation, ventilation, and chest tube insertion at birth due to respiratory distress. He also developed pneumoperitoneum which had to be decompressed. Within 24 hours the infant passed, despite advanced care. On autopsy, external examination showed central and peripheral cyanosis and a large omphalocele containing the heart, parts of the liver and intestines. Initial internal examination revealed a hypoplastic left lung, anterior diaphragmatic defect and absence of the pericardium. Organ dissection post-fixation showed an overriding aorta, pulmonic stenosis, subaortic valve ventricular septal defect and right ventricular hypertrophy, all components of tetralogy of Fallot. On brain examination, the olfactory groove and bulb were both absent. Examination of the placenta and 3 vessel cord revealed no abnormalities. Chromosomal microarray analysis on cord blood was normal. Conclusion The spectrum of defects seen in this disease complex has been postulated to be due to failure of differentiation or migration of mesenchymal structures during embryonic development but ultimately, this entity is not well understood. Identifying various disease associations through autopsies can help to establish possible etiologies, and options for therapeutic interventions or screening.

No abstract