<b><i>Introduction:</i></b> Fine-needle aspiration cytology (FNAC) is an established first-line technique for the evaluation of lymphadenopathy and, with the help of ancillary testing, can in many instances obviate the need for an open biopsy. The Sydney system was recently proposed to provide consensus guidelines for the performance, classification, and reporting of lymph node FNAC. The present study was undertaken to evaluate its utility and study the impact of rapid on-site evaluation (ROSE). <b><i>Material and Methods:</i></b> A retrospective analysis in which 1,500 lymph node FNACs was reviewed and assigned a diagnostic category from the Sydney system. Cyto-histopathological correlation and adequacy parameters were evaluated. <b><i>Observation and Results:</i></b> The cervical group of lymph nodes was the commonest group aspirated (89.7%). A total of 1,205/1,500 (80.3%) cases were category II (benign), and necrotizing granulomatous lymphadenitis was the most common pathology. The 750 cases with ROSE were subclassified as follows: 15 category I (inadequate), 629 category II (benign), 2 category III (atypia of undetermined significance), 9 category IV (suspicious for malignancy), and 95 category V (malignant). Among 750 cases without ROSE, 75 cases were in category I, 576 in category II, 3 in category III, 6 in category IV, and 90 in category V. Category I was thus significantly lower in the ROSE group compared to the non-ROSE group. Overall, the risk of malignancy was L1-0%, L2-0.20%, L3-100%, L4-92.3%, and L5-100%. Accuracy parameters revealed a sensitivity of 97.7%, specificity of 100%, PPV of 100%, NPV of 99.10%, and diagnostic accuracy of 99.54%. <b><i>Discussion and Conclusion:</i></b> FNAC can be used as the 1st line of treatment for lymph node pathology. ROSE can be used as an add-on to FNAC for reducing unsatisfactory rates and help triage material for ancillary testing whenever possible. The Sydney system should be implemented for achieving uniformity and reproducibility.
To know the incidence of leiomyoma in hysterectomy specimens and study the degenerative changes of leiomyoma and its variants. A prospective study of 1000 hysterectomy specimens was done. All the chief complaints, gross features and microscopic findings were recorded. The most common benign lesion found was leiomyoma in 55.4% cases followed by adenomyosis in 32.5% cases. Majority of leiomyoma cases (99.2%) were usual leiomyoma. 2 variants of leiomyoma, 1 case of cellular leiomyoma and other case of mitotically active leiomyoma were found. Leiomyoma was the most common pathology found in hysterectomy specimens in our study which is also true for other countries. Adenomyosis identified on histopathological examination was seen to be an important lesion in cases presenting with DUB. Hence, cases presenting with DUB should be thoroughly evaluated to rule out any underlying pathology.
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