Background: Lymphadenopathy is one of the most common clinical presentations and major causes of morbidity. Thus, clinical recognition and urgent diagnosis is of paramount importance. So, we aimed to analysis the diagnostic role of fine needle aspiration cytology (FNAC) in superficial lymphadenopathy in a regional cancer centre, Odisha, India.Methods: A total 1129 cases were retrieved from the hospital record retrospectively from the patients who had presented with superficial lymphadenopathy from January 2015 to December 2015.Results: Out of 1129 lymphadenopathy cases, 671 (59.43%) were male and 458 (40.56%) were female with male to female ratio 1.46:1. The age of the patients ranged from 4 years to 83 years with mean age 48.57 years. The most common site was observed in cervical lymph node 493 (43.66%) followed by submandibuar lymph nodes 198 (17.53%) and supraclavicular lymph nodes 172 (15.23%). 584 (51.27%) were malignant and 545 (48.27%) were benign. Reactive hyperplasia was most common 318 (58.34%) among benign cases where as metastatic squamous cell carcinoma was the most common 261 (50.77%) among malignant lesions. By FNAC all benign lesions were correctly diagnosed, and primary sites of malignancy identified in 442 (85.59%) cases. Cyto-histo correlation was done in 399 cases. The overall diagnostic accuracy of FNAC was found to be 93.98%, sensitivity 93.88%, specificity 94.64%, positive predictive value 99.8% and negative predictive value 71.62%.Conclusions: FNAC is a highly sensitive and specific tool for early detecting primary malignancy and metastatic lesions. Many inflammatory lesions can be treated based on FNAC alone.
Purpose The timely management of cancer surgery suffered due to COVID-19 and nationwide lockdown. Continuing cancer surgery was a challenge faced by all. We present our experience on cancer surgery in a cancer centre with high volume of patients and limited resources during early pandemic. Methods We retrospectively analysed our operation theatre database on surgery and anaesthesia from 1st April to 30th June 2020. Results A total of 457 surgeries were done-complex major, major, intermediate and minor surgeries constituted 43%, 25%, 12% and 20%, respectively. Median age of patient was 50 years, and 76% were below 60. The median ASA class was I (I-IV), and 97% were ASA I and II. The median Eastern Cooperative Oncology Group score was 0 (0-3), and 92% had score 0 and 1. Major cases done under regional anaesthesia were 30.7%. Median length of intensive care unit stay was 1 (1-6) days, and length of hospital stay was 7 (7-15) days. Clavien-Dindo Grade II complication in patients above 60 years was 16.4% and below 60 years was 17.6% (p = 0.76). 10% in ASA I compared to 26% of ASA II (p = 0.00) and 15.9% with ECOG 0 and 1 compared to 30.9% with ECOG 3 and 4 (p = 0.01) had grade II complication. Four (1%) patients had Grade C III CD complication. Covid testing was undertaken in 52% patients pre-operatively, and there was no positive case in post-operative period. Conclusions Adopting and implementing institutional policy catering to limited resource available at our centre, we facilitated cancer surgery.
Oral lesions of tuberculosis though uncommon, are seen in both the primary and secondary stages of the disease. Primary oral tuberculosis is very rare and may present a diagnostic challenge for the clinician. This article presents two rare cases of oral tuberculosis manifesting as non-healing oral ulcers which were suspected to be squamous cell carcinoma on clinical examination. The cases were detected initially by exfoliative cytology of oral ulcer and subsequently confirmed by histopathological examination and Ziehl Neelsen (ZN) stain of the cytosmears. The patients underwent anti-tuberculosis therapy and the oral conditions improved rapidly. Although oral manifestations of tuberculosis are rare, it should be considered in the differential diagnosis of various types of oral ulcers with the non-healing tendency.
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