Axillary lymph node (ALN) status is considered to be the single most important prognostic indicator in patients with breast cancer. It can be assessed by various radiological, pathological and surgical techniques, the most accurate being histological examination of lymph nodes after axillary lymph node dissection (ALND). This prospective study was conducted to assess the feasibility and diagnostic accuracy of preoperative ultrasound (US) and ultrasound-guided fine-needle aspiration cytology (USG-FNAC) of ALN in patients with breast cancer. Thirty patients with FNAC-proven breast cancer, planned for definitive surgery with axillary clearance, were included in this study. Ultrasonographic evaluation of the axillae of these patients was conducted for alterations in size, shape, contour and cortical morphology of lymph nodes that could reflect presence of underlying metastases. Ultrasound-guided fine-needle aspiration cytology of the ALN was done in 24 of these patients. These findings were evaluated, with the ALN status determined by histological examination after ALND. Out of the 30 patients, eight had T(1), 16 had T(2), five had T(3), and one had T(4) lesions. Ultrasound evaluation of the ALN had a sensitivity of 86.3%, a specificity of 41.6%, a positive predictive value of 79%, a negative predictive value of 50% and a diagnostic accuracy of 73.3%. Sensitivity of USG-FNAC was 78.95%, specificity was 100%, positive predictive value was 100%, negative predictive value was 55.56% and diagnostic accuracy was 83.33%. Our study concludes that preoperative USG-FNAC of ALN is a simple, minimally invasive, easily available and reliable technique for the initial determination of ALN status in patients with breast cancer. Those who are USG-FNAC positive can be directed towards ALND straight away, and only those who are USG-FNAC negative should be considered for sentinel lymph node biopsy. This will save considerable operating time, especially where facilities for sentinel lymph node biopsy (costly dye, gamma camera, nuclear medicine facilities) are restricted or not available.

Introduction A significant number of postmenopausal women suffer from distressing problems because of urogenital atrophy secondary to the decline in circulating estrogen levels. Treatment with topical hormones may provide relief in such women when used judiciously. Aim To study the effects of local estrogen with or without local testosterone on urogenital and sexual health in postmenopausal women. Methods Seventy-five postmenopausal women symptomatic for urogenital atrophy and sexual dysfunction were randomly divided into two study groups and one control group. The women in study group 1 received local estrogen cream; study group 2 received local estrogen and testosterone cream; the control group received nonhormonal lubricant KY gel for 12 weeks. The urogenital and sexuality score, along with the vaginal health index and the vaginal maturation index (VMI), was calculated at the beginning of therapy and 12 weeks later. Main Outcome Measures Changes in the urogenital and sexuality score along with vaginal health index and VMI. Results After 12 weeks of therapy, there was a significant improvement in all the four study parameters, which correlated well with the improvement in symptoms of urogenital atrophy and sexual dysfunction in both the study groups as compared with the control group. Improvement in sexuality score was greatest with combined estrogen–androgen therapy. There were no adverse effects and the therapies were well accepted without any compliance issue. Conclusion Local estrogen either alone or with androgen is highly effective in relieving symptoms of urogenital atrophy and in improving sexual function in symptomatic postmenopausal women.

Introduction. Controversy continues over the appropriate timing of sentinel lymph node (SLN) biopsy in locally advanced breast cancer (LABC) patients receiving neoadjuvant chemotherapy. We evaluated the feasibility and accuracy of SLN biopsy in LABC patients with cytology-proven axillary nodal metastasis who become clinically node-negative after neoadjuvant chemotherapy. Materials. 30 consecutive patients with LABC, who had become clinically node-negative after 3 cycles of neoadjuvant chemotherapy, were included in the study. They were then subjected to SLN biopsy, axillary lymph node dissection, and breast surgery. Results. Sentinel nodes were successfully identified in 26 of the 30 patients, resulting in an identification rate of 86.67%, sensitivity of 83.33%, false negative rate of 20%, negative predictive value of 72.73%, and an overall accuracy of 88.46%. No complications were observed as a result of dye injection. Conclusions. SLN biopsy is feasible and safe in LABC patients with cytology-positive nodes who become clinically node-negative after neoadjuvant chemotherapy. Our accuracy rate, identification rate, and false negative rate are comparable to those in node-negative LABC patients. SLN biopsy as a therapeutic option in LABC after neoadjuvant chemotherapy is a promising option which should be further investigated.

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Objective: The present study is based on the cytologic evaluation of bronchial brushings for the diagnosis of non neoplastic and neoplastic bronchopulmonary lesions and relation of the cytologic findings with clinical diagnosis and histopathologic examination wherever possible. Material and Method:35 symptomatic patients were selected on whom bronchoscopy was done. Bronchial brushing was performed using straight brushes and bronchial washing specimens were collected after brushing samples. Smears were stained by PaP, H&E, and Giemsa in all the cases while PaS and ziehl neelsen stainings were done in selected cases. Endobronchial biopsy was performed using a flexible long biopsy forceps. Results:The age of the patients varied from 18 to 88 years, and the male:female ratio was 3.3:1. Carcinoma was diagnosed in 21 (60%) out of total 35 cases on bronchial biopsy and the remaining 14 cases (40%) showed inflammatory, tuberculous or no significant pathology. Bronchial washing showed 10 true positive, 10 true negative, 4 false positive and 11 false negative cases whereas bronchial brushing showed 17 true positive, 12 true negative, 2 false positive and 4 false negative cases as confirmed on biopsy. Bronchial brushing showed good sensitivity (80.9%) and specificity (85.7%) compared to bronchial washing which had sensitivity of 47.6% and specificity of 71.4%. Conclusion:These findings attempted to confirm the concept that pulmonary cytology has improved to the point that its sensitivity is high enough to justify its use as a definitive diagnostic tool in those cases in which tissue diagnosis is not possible.Key Words: Cytology, Pulmonary neoplasms, Pulmonary abscess, Tuberculosis, Chronic bronchitis ÖZ Amaç: neoplastik ve non-neoplastik akciğer lezyonlarında bronş fırçalama materyalinin sitolojik değerlendirme sonuçlarını klinik tanı ve histopatolojik inceleme sonuçları ile karşılaştırmak. Gereç ve Yöntem:Bronkoskopi yapılan 35 semptomatik olgu değerlendirmeye alındı. rutin bronş fırçalaması ve ardından bronş yıkama sıvısı alındı. Yaymalar PaP, H&E ve Giemsa ile, gereken olgularda ek olarak PaS ve ziehl neelsen ile boyandı. ayrıca, biyopsi forsepsi ile endobronşial biyopsi alındı.Bulgular: olguların yaşı 18-88 arasında değişiyordu ve erkek:kadın oranı 3.3:1' di. 35 olgunun 21'inde (%60) karsinom saptanırken, diğer 14 olguda (%40) enflamatuvar lezyon, tüberküloz veya patoloji olmadığı saptandı. Bronş iğne biyopsisi ile değerlendirildiğinde bronş yıkama materyali 10 gerçek pozitif, 10 gerçek negatif, 4 yanlış pozitif, 11 yanlış negatif sonuç verirken, bronş fırçalama materyali 17 gerçek pozitif, 12 gerçek negatif, 2 yanlış pozitif, 4 yanlış negative sonuç verdi. Bronş fırçalaması iyi duyarlılık (%80,9) ve özgüllük (%85,7) gösterirken, bronş yıkamasında duyarlılık %47,6 ve özgüllük %71,4 düzeyinde kaldı.Sonuç: Sonuçlar, doku tanısı yetersiz olduğunda akciğer sitolojisinin tanısal olarak kullanılabilecek duyarlılığa sahip olduğu görüşünü desteklemektedir

Ameloblastoma is the most common epithelial odontogenic tumor, comprising 1% of tumors and cysts arising in the jaws. We describe two cases of ameloblastoma of the jaw diagnosed by fine‐needle aspiration cytology. The patients presented with swelling in the parotid region. Cytological examination of the particulate and sticky bloodstained fluid obtained on aspiration showed tightly packed groups of basaloid cells arranged in nests with rounded edges. Palisading epithelial cells and squamous cells with spherical keratinized bodies were the distinctive cytological features. Histologic examination confirmed the presence of ameloblastoma. Diagn. Cytopathol. 2000;23:414–416. © 2000 Wiley‐Liss, Inc.

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Microfilariae have been reported as coincidental findings with various neoplasms. We present a case in which microfilariae were encountered in fine-needle aspiration (FNA) smears from a 10-yr-old boy who presented with a lytic lesion in the diaphysis of the right tibial bone. Stained aspirates from the swelling were composed of a dispersed population of small round cells with scanty to vacuolated cytoplasm. Two sheathed microfilariae with several nuclei and cephalic and caudal clearing were identified. A diagnosis of Ewing's sarcoma with presence of microfilariae of Wuchereria bancrofti was made. The diagnosis of Ewing's sarcoma was confirmed on histopathology.