OBJECTIVES Lymphoma often presents with a neck mass and while fine-needle aspiration cytology may be suggestive, tissue biopsy is required for reliable diagnosis and classification of a lymphoma that is sufficient to deliver the correct treatment for the patient. Traditionally, excisional biopsy of a lymph node has been the standard method of tissue sampling, providing ample tissue for assessment. However, this requires theatre time, and preceding fine-needle aspiration cytology, which may incur a delay. With careful use of tissue, coupled with advances in immunohistochemical and molecular investigative techniques, core biopsy provides a possible alternative to traditional fine-needle aspiration and excisional biopsy. In this study, we aimed to determine the efficacy of diagnosing neck masses. METHOD A retrospective analysis was performed of patients being investigated for a neck mass who were undergoing ultrasoundguided core biopsies of cervical lymph nodes over a 17-month period. The final histology report was scrutinised to assess whether adequate tissue was obtained to allow for full tissue diagnosis. RESULTS Over the 17-month period analysed, 70 patients with cervical lymphadenopathy underwent core biopsy. Of these, 63 (90%) were diagnostic for either lymphoma or other pathology and did not require further tissue sampling. Overall, 19 patients were diagnosed with lymphoma, of which only 1 required further biopsy due to inconclusive initial core biopsy. CONCLUSIONS Current guidelines for investigating lymphomas require that excisional biopsy be performed to obtain ample tissue to allow full nodal architecture assessment and ancillary investigation to reach an accurate histological classification. Within our head and neck multidisciplinary team, however, it is considered that results from core biopsies can be obtained in a more timely fashion and with histological accuracy equal to those of open biopsy. The results obtained demonstrate that core biopsy is an effective tool for investigation. We believe this should be the first-line investigation of choice, as it reduces the need for patients to undergo surgery, is more cost effective and offers a faster diagnosis.

Background: Cervical lymphadenopathy is a commonly encountered presenting complaint in out-patient departments. There are many reasons for cervical lymphadenopathy in a range spanning from benign through infective to malignant pathology. This study aims to find out the proportion of malignancy in such patients.Methods: 100 patients with cervical lymphadenopathy who fulfilled the criteria were included in the study from January 2015 to June 2016. Each patient underwent clinical examination and investigations including ESR, total count, fine needle aspiration cytology and biopsy.Results: Out of the 100 cases examined, 19 (19%) had malignancy. Among them, 6 (6%) had primary malignancy and 13 (13%) had secondary malignancy. 25 (25%) had tuberculous lymphadenopathy and 46 (46%) had reactive hyperplasia.Conclusions: There is significant incidence of malignancy in patients with cervical lymphadenopathy. The most common was metastatic lymph node from a primary malignancy. It is important to keep this in mind while evaluating a case of cervical lymphadenopathy.

Background: Thyroid is an important endocrine gland regulating the metabolism of body from utero to maturation. Thyroid related diseases are most common among all endocrine diseases. Hyperthyroidism causes major metabolic derangement and hence the need for a screening test to diagnose the disease holds greater public health importance in a populated country like India. The study aims at finding the sensitivity of Wayne’s Criteria in correlation with Biochemical analysis in screening Hyperthyroidism.Methods: A prospective study done to screen patients with symptoms suggestive of hyperthyroidism coming to surgery department of Dr. S. M. C. S. I. medical college over a period of one year from September 2016 to September 2017 with the aid of Wayne’s Diagnostic criteria and biochemical analysis.Results: Of the total 53 cases studied, 23 cases were biochemically hyperthyroid. of the 23 cases Wayne’s criteria identified 20 cases as hyperthyroid, 2 cases were Disambigous and 1 was diagnosed as Euthyroid. Of the 30 biochemically Euthyroid patients Wayne’s criteria picked up 27 true Euthyroid patients, 2 patients as Disambigous and 1 patient was falsely diagnosed as Hyperthyroid. Sensitivity of the criteria was found to be 86.9%, specificity as 96%, positive predictive value was 95.2% and Negative predictive value was 90%.Conclusions: Wayne’s criteria holds a good deal of diagnostic accuracy. With high sensitivity specificity Wayne’s criteria can be applied as a screening test to diagnose a hyperthyroidism for early diagnosis and referral at the primary health care level in a populated country.

Background: Total thyroidectomy is a commonly performed surgery. Postoperative hypocalcemia is a worrisome complication which can be treated if recognized early. We analysed serum phosphorous as a potential marker of postoperative hypocalcemia.Methods: The study was a cross-sectional study done in our tertiary care hospital. We analysed the serum phosphorous levels of 50 patients who underwent total thyroidectomy at our institution. The incidence of hypocalcemia was documented and analysed with respect to serum phosphorous.Results: In the study, 18 (36%) had hypocalcaemia on third postoperative day and 32 (64%) had no hypocalcaemia. There was no relation between post thyroidectomy day one serum phosphorus value and post-thyroidectomy day three serum calcium value (p=0.709).Conclusions: The study did not find any statistically significant association between serum phosphorous and post-thyroidectomy serum calcium levels.

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