Background: The Bethesda system of reporting thyroid cytopathology is a standardised system, improving communication between cytopathologists and clinicians, leading to more consistent management approaches. The aim of the research work was to study the utility of Bethesda system in reporting thyroid cytology with histopathological correlation of all the cases undergoing surgical resection.Methods: We studied all the thyroid cytology cases received between November 2012 to April 2014, and classified them according to the Bethesda system. Histopathological correlation was done for all the cases which underwent surgical resection with evaluation of cyto-histological discrepancies.Results: Out of 484 cases studied, 432(89.2%) were benign lesions, 20(4.1%) were malignant,18 (3.7%) were Unsatisfactory/Nondiagnostic, 10(2%) were Follicular neoplasm/Suspicious for neoplasm, 3 (0.6%) were suspicious for malignancy, and 1(0.002%) case was reported as Atypia of undetermined significance. Out of the 54 cases available for histopathological follow-up, cyto-histological discrepancies were noted in 5 cases (9.2%). Statistical analysis of the present study showed that cytological analysis of thyroid lesions by Bethesda system has got high sensitivity (72.72%), high specificity (95.3%) with a positive predictive value of 80% and negative predictive value of 93.1% and a high accuracy (90.7%).Conclusions: Reviewing the thyroid FNAs (fine needle aspirates) using Bethesda system allowed a more specific cytological diagnosis with better interlaboratory agreement. As evidenced by its high sensitivity and specificity, Bethesda system has proven to be a very effective guide for the clinical management of thyroid nodules.
Introduction: Landsteiner ABO system of blood groups is most important for transfusion medicine and has subtypes of A Antigen, A1 and A2, upon which further groups of A and AB have been classified. Of individuals with A antigen, approximately 20% belong to A2 while rest 80% belong to A1. Anti-A1 Lectin, a cold agglutinin which destroys A1 cells is clinically significant when they react at 37°C, causing transfusion reactions. Aim:To assess the prevalence of A1 and A2 subgroups in the population. Materials and Methods:This was two year retrospective analysis of blood groups of donors coming to the blood bank of Karnataka Institute of Medical Science, Hubli, Karnataka, India.The data of the subgroups A and AB was analysed.Results: 20,864 donors were analysed. Of 5466 (26.20%) of A group, 5406 (98.90%) belonged to A1 subgroup and only 60 (1.10%) belonged to A2 subgroup. Of 1708 donors with blood group AB, 1532 (89.70%) belonged to A1B subgroup and 176 (10.30%) belonged to A2B. It was noted that A2 in AB bloodgroup, as A2B, was more frequent in occurrence than presence of A2 as an A blood group. Rhesus negative frequency in these subgroups was also reported. Conclusion:Having known the prevalence of A1 and A2 subgroups and incorporating them into the ABO grouping system can limit these minor, yet dangerous, transfusion incompatibilities.
Background: Lichenoid tissue reaction/Interface dermatitis (LTR/ID) refers to a number of clinically diverse, poorly understood and relatively uncommon inflammatory skin diseases. This study was done to understand the histopathological features of lichenoid tissue reactions in skin biopsies and to assess the concordance and disparity between the clinical and histopathological diagnosis of variants of the same.Methods: It was a 3½ years study from January 2014 to June 2017 in the department of Pathology, KIMS, Hubballi. The present study included skin biopsies of clinically diagnosed and suspected cases and histologically diagnosed cases of LTRs. Skin biopsies received were routinely paraffin processed and H&E stained to study the microscopic features.Results: Out of 166 skin biopsies studied, 148 were histologically confirmed as LTR with majority being of lichen planus (LP) (91.22%). Classical lichen planus was the most common variant of lichen planus among lichen planus cases. Male:female ratio was 1.2:1. Clinico-pathological concordance was seen in 88.55% of the cases.Conclusions: Though definite diagnosis can be made on histopathological examination, size of specimen, site of biopsy, nature and depth of biopsy, quality of sections, treatment history and inter-observer variation (both clinically and histologically) should be kept in mind which may lead to clinicopathological discordance.
Introduction: FNAC is the first line diagnostic test for evaluation of thyroid lesions. Identification of cytological features is key element in diagnosing thyroid lesions, which will reduce the number of unnecessary surgeries of thyroid nodules. Bethesda system of reporting helps the clinicians to take appropriate therapeutic intervention. Aim: To study the cytomorphological features of various thyroid lesions and to categorize as per Bethesda system proposed by NCI Bethesda USA in 2007. Materials and Methods: This is a prospective study of cases of thyroid lesions received in cytology section of Department of Pathology, KIMS Hubballi, during Jan 2017 to Dec 2017. FNAC was performed and reported according to Bethesda system. Results: FNAC was performed on 370 cases of thyroid lesions. Maximum number of cases were in the age group of 21-30 years.Male to female ratio was 1: 9.27. Maximum number of cases presented in less than 6 month duration. Most of the cases presented with swelling in the neck. Out of the total 370 cases, 351were benign lesion, 6 cases were malignant, 8 were unsatisfactory, 3 were follicular neoplasm/suspicious of follicular neoplasm, 1 was suspicious for malignancy and 1 was follicular lesions of undetermined significance. Out of 351 benign lesions, commonest was colloid/ nodular goiter, followed by lymphocytic/Hashimotos thyroiditis. Conclusion: FNAC is the most simple, rapid and safe diagnostic test for evaluation of thyroid lesions with high degree of accuracy. Bethesda system of reporting thyroid cytopathology is very useful as it is systematic and standardized and hence provides better communication between clinicians and cytopathologist for appropriate therapeutic intervention.
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