BACKGROUND:Lymphadenopathy is a commonly encountered clinical problem. Fine needle aspiration cytology offers the alternative of an immediate, preliminary, although not always specific diagnosis with little trauma and cost, thus providing ample information for further management and reduce the amount of open biopsy. MATERIAL AND METHODS:FNAC was performed using 21 gauge needle attached with 10ml disposable needle. Slides were prepared, two were air dried and stained with field stain where as two were fixed in ethanol and was stained with PAP stain. One slide was stained with Ziehl-Neelson stain. Field and PAP stained slide were reviewed and diagnosed by Pathologist. RESULT:Out of the 225 patients, reactive lymphadenitis was the most common diagnosis (54.2%), followed by tubercular lymphadenitis (33.44%). Among the age group percentage of tubercular lymphadenitis was more in 21-30 years of age. Majority of the metastatic carcinoma was in cervical region, comprising mainly squamous cell carcinoma. CONCLUSION:Reactive lymphadenitis was the most common cause of lymphadenopathy especially in case of children. In case of older population, definite pathology for lymph node enlargement was found in most of the cases. Hence FNAC is warranted in lymphadenopathy, as it is simple yet of great diagnostic value.

Subacromial-subdeltoid bursitis of a shoulder with rice bodies is relatively uncommon. The understanding of the pathogenesis of rice body formation is yet approximate only but some clinical conditions like rheumatoid arthritis, tuberculous arthritis, seronegative inflammatory arthritis, juvenile rheumatoid arthritis and osteoarthritis are related to it. We describe a case of a 44 years old female with subacromialsubdeltoid bursitis of her right shoulder with numerous rice bodies' formation as a presenting feature of rheumatoid arthritis. She underwent subacromial and subdeltoid bursectomy with the removal of rice bodies and had immediate improvement of symptoms.

Background: Carcinoma cervix is among a curable cancer, if identified at an early stage. Pap smear is a simple, safe, noninvasive, outdoor and effective method for detection of lesions of the cervix but it fails to localize the lesion. Cervical biopsy, on the other hand is a gold standard but invasive technique.Materials and Methods: A prospective cross-sectional study was done in Nobel medical college from January 16, 2017 to January 15, 2018 where all pap smears received in a Department of Pathology were included in the study. However, only cases that had undergone both Pap smear and cervical biopsy were compared. Out of the 1492 pap smears, 118 cases underwent biopsy. Correlation was then done regarding cytological and histological diagnosis.Results: Majority of the cytological findings were normal. 7 patients of HSIL revealed moderate dysplasia and higher lesions in biopsy. 2 cases were that of adenocarcinoma which were diagnosed as inflammatory smear in Pap smear.Conclusion: Cervical Pap smear is reliable screening test to identify high grade squamous cell lesions and carcinoma, but it fails to localize the lesion and adenocarcinoma is hard to identify in a pap smear. Hence, cervical biopsy should be carried out to confirm the findings of Pap smear and in case of strong clinical suspicion.

Background: It is estimated that 9-30% of women of reproductive age suffer from menorrhagia. Because most cases are associated with anovulatory menstrual cycles, adolescent and perimenopausal women are particularly vulnerable to this particular condition. The aim of this study was to evaluate the histopathological pattern of endometrial biopsy from patients presenting with dysfunctional uterine bleeding.Materials and Methods: This is a cross-sectional observational study done in Nobel Medical College, Biratnagar, Nepal for a period of three years from June 2012 to June 2015. All the patients presenting with dysfunctional uterine bleeding and who underwent endometrial biopsy were included in this study. Distribution of various histopathological patterns was observed in the different age groups.Results: A total of 300 cases were included in my study. The commonest pattern in these patients was proliferative endometrium 61 (%). The commonest pathology was simple cystic hyperplasia (13.3%). Other patterns identified were secretory endometrium, chronic endometritis and pill endometrium. Malignant lesion comprised of 8 (2.7%) of patients and the majority was in >50 years followed by in between 41-50 years of age. Atrophic endometrium was the commonest finding in post menopausal bleeding, comprising of 11 cases (3.6%), followed by endometrial carcinoma of 8 cases (2.7%).Conclusion: As observed from the study, there is an age specific association of endometrial bleeding, with highest incidence in perimenopausal age group. Hence, dilatation and curettage is helpful for diagnosis, to assess therapeutic response and to know the pathological incidence of organic lesions in cases of dysfunctional uterine bleeding.

A mixed adenoneuroendocrine carcinoma is a tumor composed of both adenocarcinoma and neuroendocrine carcinoma components, with each comprising at least one-third of the lesion, as defined by the World Health Organization classification of neuroendocrine neoplasms in 2010.. A 67-years-old male was admitted to the hospital with symptoms suggesting gastric cancer. Histopathology examination from endoscopic biopsy revealed adenocarcinoma. Later partial gastrectomy specimen examination the lesion show presence of well differentiated adenocarcinoma along with neuro endocrine carcinoma.

Introduction: Bone marrow examination is an important diagnostic tool to evaluate various disorder including both neoplastic and non-neoplastic hematological diseases. The two most important techniques used for the diagnosis are bone marrow aspiration and bone marrow trephine biopsy which are complementary to each other.Aim and Objectives: To compare the diagnostic value of bone marrow aspiration and biopsy. Material and methods: A total of 88cases with both bone marrow aspiration and biopsy were included in the study. All the aspirate smears were routinely stained by Jenner Giemsa while the trephine biopsy sections were stained by routine Hematoxylin and Eosin stain.. All the smears and sections were reviewed and the findings on BMA and BMB were compared and the final correlation done.Result: Hypolastic marrow was the most common diagnosis followed by immune thrombocytopenic purpura (ITP). But the diagnostic accuracy of ITP on aspiration was 100 % in compare to hypoplastic marrow (81.25%). The diagnosis accuracy of BMA in our study was 84.09%.Conclusion: Bone marrow aspiration and biopsy complement each other. Bone marrow aspiration provides better study of the cell, whereas biopsy provides detail about the pattern of cellular distribution, hence when performed together it gives better diagnostic accuracy. Journal of Nobel College of Medicine Vol.4(1) 2015: 12-14

Background: Fine needle aspiration cytology is used as a primary diagnostic tool in thyroid lesions. But the bloody smears caused by negative pressure during aspiration compromise cellular concentration and cell morphology which may lead to its improper interpretation. FNNAC avoids active aspiration and depends on capillary tension to collect tissue sample in the needle bore, thus reducing bleeding and tissue trauma to the highly vascular thyroid. Material and Methods: This is a one year prospective study where FNNAC and FNAC were done on 87 patients. Cytopathologist was blind folded regarding the technique used and was asked to score the quality of slide base of Mair scoring system.Results: FNAC yielded significantly better material on the basis of hemorrhage and cellularity. Fifty six (64.37%) cases showed adequate diagnostic material in FNNAC technique while 54/87 (62.05%) cases showed adequate diagnostic material in FNAC technique. Twelve (13.79%) cases showed unsuitable diagnostic material in FNNAC technique and 26/ 87 (29.89%) cases unsuitable diagnostic material in FNAC technique. Among the individual criteria used in Mair scoring system, background clot/ blood was significantly low in FNNAC than FNAC with the p value less than 0.001. Amount of cellular material was significantly more in FNNAC with p value less than 0.001.Conclusion: FNNAC yielded more cellular and less hemorrhagic material and more diagnostic superior material than FNAC. Since thyroid is a highly vascular gland, FNNAC should be used instead of FNAC for less hemorrhagic and more cellular material.

Background: Thyroid lump is a common clinical problem in Nepal. The risk of malignancy has to be judged prior to surgery for which fine needle aspiration cytology is widely used. To bring the uniform reporting of thyroid aspirates, the Bethesda system for reporting thyroid cytopathology (TBSRTC) was introduced in 2007. This study was done to evaluate the various cytomorphological patterns of thyroid aspirate and to correlate the Bethesda system with final histopathology report. Materials and Methods:Fine needle aspiration were performed and were evaluated as per TBSRTC criteria. Fine needle aspiration cytology report were compared with biopsy specimen whenever possible.Results: A total of 386 cases were studied. The sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of TBSRTC were 75.2%, 98.2%, 90.0%, 94.7% and 94.03% respectively. Conclusion:Use of TBSRTC in reporting thyroid cytopathology has a greater accuracy; however, benign cases need regular follow up as there are false negative cases.