Follicular lymphoma (FL) is a common form of non-Hodgkin's lymphoma (NHL) with the ability to transform into a more aggressive disease, frequently to B cell-lymphoblastic lymphoma. Diffuse large B-cell lymphoma (DLBCL) is a subtype of NHL, which is characterized by diffuse proliferation of large neoplastic B-lymphocytes. It accounts for 30% of all NHL and its occurrence in the mandible is very rare. It is often seen in young adults, but in the present case, a 50-year-old male patient presented with painless swelling in left lower jaw since 25 days following extraction of left lower molar teeth. There was a history of fever and submandibular lymph nodes were enlarged. On incisional biopsy, features of NHL-like lesion were observed and confirmed by immunohistochemistry using CD20, bcl-2, CD10, CD3, CD5, Ki67 markers to be FL (3A) lymphoma transforming into DLBCL. This is a very uncommon presentation.

QUESTIONS TO BE ANSWEREDIn this retrospective study we have correlated the clinical, ultrasonological and pathological findings of breast masses to answer whether we could rely on ultrasound and Fine Needle Aspiration (FNAC) findings for the further management of patients. MATERIAL AND METHODSThis is a retrospective study done at Vidya Cancer Hospital, Gwalior, Madhya Pradesh, India. This study has included patients from Jan. 2014 to Jan. 2016. The total number of patients is 50. The clinical examination is done by an oncology team which includes a surgical oncologist, medical oncologist, radiation oncologist and gynaecologist. The ultrasound is done by an oncoradiologist. The pathological examination is done by an oncopathologist. The ultrasonology findings assessment is done according to the American College of Radiology, Breast Imaging Reporting and Data System (BI-RADS). The statistical analysis is done by using standard formulas. DISCUSSIONIn our day-to-day practice, we often see so many breast lumps. All the patients and their family members are in great agony. We as clinicians have to give quick results by non-invasive methodology. In today's era nothing could be advocated merely on clinical experience, it has to be evidence based. To create evidence, we have done this study. We found even a good clinical examination and ultrasound by a good team could solve most of the diagnostic dilemmas of breast masses. In our study, the sensitivity and specificity of clinical examination were 100% and 88% respectively. We tried to compare it with other studies, but we were unable to compare it with because of wide variations in those studies for they were either not focusing on clinical examination or it was not a team effort. Yes, we have been able to compare the sensitivity and specificity of ultrasound and FNAC findings. In our study, the sensitivity and specificity of ultrasound was 100% and 88% respectively which was comparable to 95.7% and 89.2% respectively in Lehman et al Study. In our study the sensitivity and specificity of FNAC was 93.3% and 88% respectively, which was 66.6% and 81.8% in Homesh NA et al study. The difference in sensitivity and specificity may be because our pathologist was always in coordination with the clinicians and ultrasonologist. Apart from this, we came across very interesting finding that our pathologist was not able to give any conclusive findings in clinically suspicious an d BIRADS 4 findings. CONCLUSIONThis study has shown that a good team work could do wonders and a good clinical and ultrasonological examination could sort out most of the diagnostic dilemmas of breast masses. FNAC does well in frankly benign and malignant lesions. Any lesion which is suspicious and BIRADS 4 should undergo an upfront biopsy rather than FNAC. Fallacy was the number of patients included in this study was too small to make a final remark and secondly it is not a blinded study.

BACKGROUNDPeritonitis resulting from small bowel perforation is a frequently encountered surgical problem in India. A review of literature indicates a very high mortality associated with this condition in spite of advances in treatment. The management of ileal perforation has been a subject of controversy. Operative treatment has been generally accepted as the treatment of choice, but the choice of procedure continues to be debated.

Background: For recognizing the initial stages of breast cancer, mammography is regarded as one of the best modalities and plays a crucial part to lessen morbidity and mortality. For collaborative studies and planning of preventive strategies, it is significant to have baseline data. Thus, in this survey, the frequency distribution of breast imaging reporting and data system (BIRADS) classification and breast consistencies was investigated during the mammographic screening program in the Gwalior region, India. Material and Methods: A descriptive, cross-sectional survey was conducted in the Gwalior region, India, in which 1,838 patients were screened with the aid of mammography. The mammography films were evaluated by a single radiologist who determined the BIRADS score, breast composition, and any other abnormal findings. After tabulating the data into MS Excel (MS Office version 2007 developed by Microsoft, Redmond, WA), descriptive analysis and Chi-square test were performed to determine the association between the BIRADS score and breast consistency and setting significance level at (below) 0.05. Results: The most commonly found BIRADS score was score 1 (53.4%), followed by score 2 (20.4%), and score 5 was of the least frequency (1.3%). Similarly, the most common consistency found was fatty (48.2%) and the least common was heterogeneously dense (3.97%). The most BIRADS category of 0 was seen in heterogeneously dense ( n = 22; 26%) followed by dense breast compositions ( n = 18; 25%). The most common consistency found with known breast malignancy (BIRADS 6) patients was the extremely dense breast ( n = 11; 40.7%). Conclusion: In this study, it was observed that about 57.3% of all the cases were categorized as BIRADS 1 and 20.8% as BIRADS 2.

OBJECTIVESTo address issues like role of SND in clinically negative neck, role of ultrasound and ultrasound-guided FNAC in staging of the neck and followup. STUDY DESIGNA randomized prospective study. SETTINGMahavir Cancer Sansthan, Patna. METHODS50 patients with carcinoma of the buccal mucosa with clinically negative neck (cT1T2N0) during May 2009 to May 2011 were included in study, after obtaining well-informed written consent. Patients were examined with real time scanner with probe heads of 7.5 MHz frequency transducer. The most suspicious lymph nodes were aspirated. If positive they were randomized to neck dissection arm. Patients were then randomized to observation arm and neck dissection arm. In neck dissection arm, who have not met most suspicious lymph node criteria have undergone SND (I-III) and who were positive on FNAC have undergone MRND II (I-V). Correlation of clinicopathological variables with lymph node status was done. Patients were followed till printing of this poster. Followup visits were performed at 4-8 weeks interval. Apart from routine examination, USG was done in all patients in observation arm. For regional recurrence, MRND II was done. Data was analysed with SSPS 16.0 software windows. RESULTSA wait-and-see policy using USG and USG-FNAC has 8% recurrence rates with 100% salvage rates. CONCLUSIONProphylactic supraomohyoid neck dissection (Level I-III) is now an acceptable method of elective neck dissection in T1-T2 cancer of buccal mucosa with clinically N0 neck. A wait-and-see policy of the N0 neck after transoral tumour excision only seems feasible if a strict and accurate follow-up regimen can be provided. KEYWORDSNeck Dissection, USG. HOW TO CITE THIS ARTICLE:Mittal M, Agrawal G, Agrawal A, et al. Role of prophylactic supraomohyoid neck dissection v/s USG along with USG FNAC in management of clinically T1 T2 N0 squamous cell carcinoma of buccal mucosa.