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.
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