Childhood spondylodiscitis is an extremely rare entity and accounts for 2-4% in neonates. Respiratory and other site infections are identified as sources of hematogenous spread. A 5-week-old male child was brought to the emergency department with respiratory distress and convulsions. On the evaluation, he had bilateral bronchopneumonia with septicemia and kyphosis. Computed tomography scan demonstrated spondylodiscitis with destruction of T 5-T 6 vertebrae with abscess of right lower lobe of the lung. Subsequently, thoracotomy was done, and a biopsy sent from apical and posterior segments of the lower lobe of the right lung revealed bronchopneumonia, abscess with entrapped dead bony spicules and collapse. Early diagnosis and treatment of respiratory infections are critical as delay may result in vertebral destruction as seen in this case and could lead to potentially life-threatening complications.
Introduction: The early diagnosis of breast carcinoma is of paramount importance in its management. Fine Needle Aspiration Cytology (FNAC) has the potential to play a pivotal role in providing the relevant information on the aggressiveness of this tumor. But there is no gold standard when it comes to cytological grading of breast carcinoma as there is no consensus between the pathologist and also the clinicians as to which grading is as par with the gold standard Elston -Ellis modification of Scarff-Bloom-Richardson (SBR) histological grading. This study was undertaken to study seven cytological 3-tier grading systems, namely Robinson’s, Fisher’s, Mouriquand’s, Dabbs’, Khan’s, Taniguchi’s and Howells’s and to correlate them with the Elston-Ellis modification of Scarff-Bloom-Richardson (SBR) histological grading system so as to determine the finest cytological grading system which could be reliably used in our routine practice
Material & Methods: A total of 117 breast carcinoma cases diagnosed on FNAC were graded using seven 3-tier cytological grading systems and were correlated with Elston-Ellis modification of Scarff-Bloom-Richardson (SBR) histological grading system. Concordance, kappa measurement and various correlation studies were done using SPSS software version 2021.
Results: Robinson’s method showed a better concordance (84.61%), a better correlation (Spearman 𝜌 = 0.750, tau = 0.731, p= <0.001) and a substantial kappa value of agreement (𝜅 =0.701) with SBR grading system compared to other system closely followed by Fisher’s system.
Conclusions: Even though all the seven 3-tier cytological grading systems positively correlated with the SBR histologic grading of breast carcinoma, Robinson’s method showed better concordance and correlation with a substantial kappa value of agreement in comparison to other 3-tier cytology grading systems. Hence Robinson’s grading which is simpler and also feasible should be incorporated in the routine cytology reporting of breast carcinoma.
Key Words: Robinson’s grading, 3-tier Cytological grading, Scarff-Bloom-Richardson grading, Breast Carcinoma
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