Background: Fine Needle Aspiration Cytology (FNAC) is a simple and rapid diagnostic technique. Because of early availability of results, simplicity, minimal trauma and complications, the aspiration cytology is now considered a valuable diagnostic aid and is part and parcel of a pathologist's repertoire. Objectives: The aim of the study was to evaluate the results of ¿ ne needle aspiration cytology (FNAC) of lymph nodes in our institution in comparison to result of histopathology. Male to female ratio of the patients was 1: 0.9. Th age of patients ranged from 3 to 85 years. FNAC diagnosis was found to be as follows : reactive hyperplasia 54( 41.55%), tubercular lymphadenitis 36 (28 %), metastatic carcinoma 16 (12.3%), granulomatous lymphadenitis 12 ( 9.2 % ), lymphoma 8 (6%) and suppurative lymphadenitis 4(3%) . Out of 28 cases of FNAC 26 (92.85%) were consistent with histopathological diagnosis of tubercular lymphadenitis. In metastatic carcinoma to lymph nodes sensitivity and speci¿ city of FNAC were 100% each. Conclusion: FNAC is useful and reliable in diagnosing neoplastic and non-neoplastic lesions of lymph nodes. It helps in planning surgery for malignant cases, where de¿ nitive operative intervention can be performed in one session.

Objectives: To determine the incidence of tuberculous lymphadenitis in enlarged neck nodes. Materials and methods: Continuous prospective study is carried out in the department of otorhinolaryngology head & neck surgery, Kathmandu Medical College, Kathmandu, during two years, from January 2006 to January 2008. The study included a group of 155 patients with cervical lymphadenopathy. Each patient underwent a detail clinical Ear, Nose and Throat (ENT) examination and a battery of investigations which included Fine Needle Aspiration Cytology (FNAC) of the nodes, Montoux's test, blood Erythrocyte Sedimentation Rate (ESR) and chest X-ray. Those patients with tubercular lymphadenitis were referred to Directly Observed Therapy System (DOTS) clinic for anti-tubercular therapy. Others with reactive lymphadenitis were treated with antibiotic and those with metastatic neck nodes were treated accordingly. Results: Of the 155 cases with enlarged neck nodes, 83 (54%) had tubercular lymphadenitis. Fifty two (33%) cases had reactive lymphadenitis and 17 (11%) cases were diagnosed with metastatic neck nodes. Fine needle aspiration cytology was found to be highly effective in the diagnosis of tubercular lymphadenitis with 94% accuracy. Majority of patients were otherwise healthy adults, aged between 8 - 71 years. No difference was observed between male and female in this study. Posterior triangle (PT) nodes were most commonly affected group of nodes accounting for 35 (42%) cases and preauricular region 1 (1%) case being the least commonly affected site. Fifteen (18%) cases presented with abscess formation. Only 42 (50%) cases had family history of tuberculosis but 8 (9%) patients had previous history of various forms of tuberculosis. Twelve (14%) patients had positive chest X-ray findings suggesting of concurrent pulmonary tuberculosis. All the patients were referred to DOTS clinic and were treated with category (CAT) - III anti tubercular therapy (ATT). Others with concurrent pulmonary tuberculosis were treated with CAT I regime. None of the patients required surgical treatment. Conclusion: There is high incidence of tubercular cervical lymphadenitis in patients with enlarged neck nodes in developing countries like Nepal. Involvement of cervical lymphnodes are the most commonly affected group of nodes. Therefore, it is important that otolaryngologists are aware of tuberculosis in the head and neck region. Key words: Tuberculosis, Lymph node, Fine needle aspiration cytology, Lymphadenitis    doi: 10.3126/kumj.v7i1.1766       Kathmandu University Medical Journal (2009), Vol. 7, No. 1, Issue 25, 54-58

Introduction: Bladder tumours constitute one of the most common urological conditions. Urothelial(transitional cell) carcinoma accounts for 90% of all primary tumours of the bladder. These tumoursare an important cause of morbidity and mortality. The objective of this study was to present thehistopathological patterns of urothelial tumours and to determine the grade and stage of thesetumours.Methods: This is a 3 year descriptive study of urothelial tumours carried out in the Departmentof Pathology, Patan Academy of Health Sciences (PAHS), Lalitpur, Nepal. Data of all cystoscopicbiopsies collected during this period were analyzed.Results: Of the 83 urinary bladder tumours, 81 (97.59%) cases were urothelial (transitional cell)tumours. Transitional cell carcinoma (TCC) was the most common bladder tumour which was seenin 67 (80.72%) cases. Thirty two (47.76%) cases of TCC were low grade while 35 (52.24%) were highgrade. Forty three (64.18%) cases of TCC were superficial or in early stage (pTa and pT1) while 24(35.82%) showed muscle invasion.Conclusions: Transitional cell carcinoma was the most common bladder cancer. Most of thesetumours were high grade. A large percentage of high grade carcinomas presented with muscleinvasion. Pathological grade and muscle invasion are the most valuable prognostic predictorsof survival. The importance of including smooth muscle in the biopsy specimens needs to beemphasized._______________________________________________________________________________________Keywords: cancer; high grade; low grade; transitional tumour; urinary bladder._______________________________________________________________________________________

Background: Prostate Specifi c Antigen (PSA) has been widely used in the diagnosis and management of patients with prostate cancer. It may be elevated in other prostatic diseases and surgical procedures. PSA exists in two forms, a major bound form (cPSA) and a free form (fPSA). Objectives: The objective of the study was to determine the relationship between serum fPSA levels and histologic fi ndings in biopsy specimens of men with prostatic disease. Material and methods:This study includes 91 patients planned for transurethral resection of prostate (TURP). Blood samples were collected before TURP and tested for fPSA. Histology of the tissue samples collected after TURP were studied and the relationship with fPSA analysed using SPSS 11.5. Results:The median values for benign, premalignant and malignant lesions were 1.8ng/ml, 4.5ng/ml and 13.20ng/ml respectively (p<0.001). Most cases of benign prostatic hyperplasia(BPH) without infl ammation had fPSA levels <2ng/ ml, while most with active infl ammation had levels >5ng/ml. Low grade prostatic intraepithelial neoplasia (LGPIN) saw levels <5ng/ml while high grade intraepithelial neoplasia (HGPIN) and prostate cancer (PCa) had levels > 5ng/mL (p<0.05). For detection of high grade lesions (HGPIN and PCa), the sensitivity and specifi city of fPSA level > 5ng/ml was found to be 88.8% and 90.2% respectively. Conclusions: Serum fPSA is elevated marginally in patients with BPH without infl ammation. Active infl ammation and high grade lesions are associated with fPSA level more than 5 ng/ml.

Introduction: Diseases of upper gastrointestinal tract are responsible for a great deal of morbidity and mortality. The histopathological study of endoscopic biopsies permits exact diagnosis for further management.The aim of this study is to find out the histopathological pattern of endoscopic biopsy.Methods: A descriptive study was conducted in consecutive endoscopic gastric biopsies in a Hospital over a period of one year. The patient of all ages and both sexes who underwent gastric biopsy during the study period was included.Results: Endoscopic biopsies were studied on patients of age ranging from 20 years female to 84 years male. The histopathology revealed non-neoplastic lesions 54 (67.5%) and neoplastic lesions 26 (32.5%). Most common non-neoplastic lesion noted was mild chronic gastritis 22(27.5%) followed by chronic active gastritis 15 (18.75%) while H. pylori was present in 13 (16.25%) and absent in 2 (2.5%).Conclusions: Mild chronic gastritis was the commonest lesion noted in non-neoplastic lesions and adenocarcinoma was the commonest neoplastic lesion in the endoscopic gastric biopsies.______________________________________________________________________________________Keywords: biopsy; endoscopy; gastritis; histopathological.