Background:The evaluation and management of discrete hepatic masses is a clinical problem. Ultrasound guided fine needle aspiration cytology (FNAC) is a rapid, accurate and safe diagnostic procedure that can be used in various neoplastic and non-neoplastic diseases of the liver.Aim:To evaluate the cytomorphological features of hepatocellular carcinoma.Materials and Methods:Ultrasound-guided fine needle aspiration was performed on 52 patients clinically suspected of having hepatic lesion.Results:Malignancy was detected in 50 cases. The primary malignancies consisted of 15 cases of hepatocellular carcinoma (HCC), 4 cases of cholangiocarcinoma and 2 of hepatoblastoma. There were 29 metastatic lesions, which included 26 cases of adenocarcinoma, 2 cases of squamous cell carcinoma and 1 of lymphoma. The key diagnostic features for HCC were trabecular arrangement, polygonal cells with eosinophilic and granular cytoplasm, hyperchromatic nuclei with macronucleoli. Atypical naked hepatocytic nuclei and malignant cells separated by sinusoidal capillaries were also commonly seen. The sensitivity and specificity of FNA for malignancies was found to be 96% and 100% respectively, yielding a positive predictive value of 100% and negative predictive value of 50%.Conclusions:There was a very good correlation of cytological criteria and histopathological diagnosis in hepatocellular carcinoma of various grades as well as in differentiating primary from metastatic tumors. It is recommended that image directed FNAC should be the primary diagnostic modality for assessing potential malignancy in any patient with a localized hepatic mass.

BACKGROUND: Beta-thalassemia syndromes are a group of hereditary blood disorders characterized by reduced or absent beta globin chain synthesis, resulting in transfusion dependent severe anemia, leading to iron overload, resulting in hypothyroidism as the most common endocrine problem. OBJECTIVE: There is lack of information about frequency of hypothyroidism in thalassemic patients in central part of India, so this was undertaken to determine the frequency of hypothyroidism in patients suffering from homozygous ß-thalassemia and to study its correlation with serum ferritin and transfusion index. METHOD: This descriptive study included 60 diagnosed thalassemia major patients aged 2-18 years. Demographic data as well as history of blood transfusion, from which transfusion index was estimated, was taken. Serum total T3, T4 and TSH by sandwich ELISA method using Eliscan kit, serum ferritin level by sandwich ELISA method using Accu-bind kit were measured from fasting blood sample. Hypothyroidism was defined by a TSH level >6.4μIU/ml. RESULTS: Study of the thyroid panel among all 60 patients showed a mean TSH level of 4.65±2.41 µIU/ml. Mean total T3 and total T4 levels were 1.35±0.48 ng/ml and 7.4±1.93 µg/dl respectively. Mean serum ferritin level was 557.25±198.66 ng/dl. Hypothyroidism was detected in 14 (23.33%) out of 60 β thalassemia patients. Out of these, compensated hypothyroid (normal T3 and T4 with raised TSH) was seen in 9 patients (15%) and decompensated hypothyroid (Decrease T3 or T4 and Raised TSH) was seen in 5 patients (8.33%). There was significant positive correlation of TSH levels with serum ferritin levels, age and transfusion index. However total T3 and total T4 did not show any correlation with serum ferritin levels, age or transfusion index. CONCLUSION: Hypothyroidism, are more common in second decade of life. Early recognition and hence prevention of these complications will definitely help to improve both the longevity & quality of life of these patients.

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Clinicopathological Correlation in Dysplastic and Malignant Lesions of The Oral Cavity and Oropharynx in Tertiary Care Center in Central India Introduction Cancers of oral cavity and oropharynx collectively come among top three cancers in India with Bhopal region in central India showing one of the highest incidence rates according to the recent National Cancer Registry Programme report. [1,2] Majority of the oral cancers are diagnosed in the advanced stages and this delay in diagnosis and treatment leads directly to increased morbidity and mortality. Early institution of therapy warrants early diagnosis of oral cancer translating to a better prognosis. Understanding the risk factors and patterns of degree of dysplasia and malignancy can help early identification and prompt treatment of patients with oral cancers. Oral and oropharyngeal cancers have a multifactorial carcinogenesis with a plethora of lifestyle and environmental factors acting as risk factors. Severe alcoholism, use of tobacco like cigarettes, smokeless tobacco, betel nut chewing and human papilloma virus (HPV), syphilis, oral sepsis, iron deficiency, oral candidiasis, Fanconi anemia, poor dental care and poor diet are the most common risk factors for oral cancer. [3-5] Due to wide range of cultural and regional differences, it is important to identify specific risk factors in a particular population. In the current study, we aimed to study the pattern of oral and oropharyngeal dysplastic and neoplastic lesions in a tertiary care center located in Bhopal region in central India and study its association with various risk factors.