BACKGROUND Enlargement of lymph nodes is called lymphadenopathy. Superficial lymphadenopathy is a common presentation in clinical practice. Fine needle aspiration cytology (FNAC) is simple, reliable and easily acceptable to the patients and has an important role in the diagnosis of superficial lymphadenopathies. MATERIALS AND METHODSThe present study is a retrospective analysis of 378 cases of enlarged, superficial lymph nodes referred to the Department of Pathology, JNIMS (Manipur), for a period of four years i.e. January 2013 to December 2016. We aim to present the various cytomorphologic diagnosis of these cases. RESULTSOur study observed that non-specific reactive lymphadenopathy was the most common pathology and was seen in 176 cases (46.56%), most common in the age group of 11 to 20 years and among females the occurrence of tubercular lymphadenopathy was also quite high and was seen in 122 cases (32%) constituting the second most common presentation. Acute suppurative lymphadenitis made up 47 cases (12.43%). Both tubercular and suppurative lymphadenopathies were seen most commonly in the age group of 21 to 30 years and also common among females. Metastatic lymph nodes were found in the age group above 60 years and constituted 19 cases (5.02%) and was seen more commonly among the male patients. Malignant lymphomas were seen commonly in the age group of 50 to 60 years, non-Hodgkin's lymphoma made up 11 cases (2.9%) with female preponderance, while Hodgkin's lymphoma was seen in only 3 cases (0.79%) and more common among males. We also observed that in all these cases cervical lymphadenopathy was the most common presentation constituting 292 cases (77.24%). CONCLUSIONSuperficial lymphadenopathy is a common clinical presentation. The underlying cause can vary from a curable inflammatory lesion to a fatal malignant lesion. In this study, we present the role of FNAC in the cytomorphologic diagnosis of various forms of superficial lymphadenopathies. KEYWORDS FNAC: Fine Needle Aspiration Cytology; Lymphadenopathy; Cytomorphology. HOW TO CITE THIS ARTICLE: Urmila K, Haobam S, Thiyam U. FNAC as a simple tool for the diagnosis of superficial lymphadenopathy-a study in an institute in the North-Eastern States of India. J. Evolution Med. Dent. Sci. 2018;7(11):13287(11): -1332/jemds/2018/302 BACKGROUND Enlarged lymph nodes are referred to as lymphadenopathy. (1) It was a common clinical finding among patients attending the outpatient department. The cytomorphological patterns of the lymph nodes would vary, depending on the causative underlying disease and the response of the organ which might range from a simple curable benign lesion to a fatal malignant pathology. (2) Fine needle aspiration cytology is a simple, reliable, inexpensive and easily acceptable diagnostic tool for superficial lymphadenopathies, (3,4) even though limitations
Background: Anti-tuberculosis drug-induced liver injury (AT-DILI) in tuberculosis (TB) patients has been linked to polymorphisms in genes encoding drug metabolism enzymes and proteins. Objective: This study aimed to monitor polymorphisms of NAT2, PXR, ABCB1, and GSTT1 genes in TB patients from three states (Manipur, Tripura, and Nagaland) in the North Eastern Region of India. Methods: Genomic DNA was isolated from the whole blood samples of TB patients (n=219; Manipur:139; Tripura: 60; Nagaland: 20). The TaqMan allelic discrimination assay and statistical tools were used to investigate single nucleotide polymorphisms (SNP) patterns in NAT2, PXR, ABCB1, and GSTT1 genes. Results: In the study population, ten distinct genotypes of the NAT2 gene and single variation in the PXR, ABCB1, and GSTT1 genes were identified. A strong linkage disequilibrium (LD) was observed between rs1801280 and rs1799931 of the NAT2 gene. Majority of the study populations were intermediate (~46.1%), rest were either slow acetylators (~35.6%) or fast acetylators. Interestingly, ~55% of the TB patients in Tripura were slow acetylators and majority in Manipur and Nagaland were of intermediate acetylator genotypes. For all of the markers investigated, the population had a greater prevalence of ancestral alleles and genotypes. According to a combinational study of the genotypes linked to AT-DILI, ~26.1% of the population possessed the risk genotypes. Conclusion: These TB patients from north eastern states of India were found as carriers of the ancestral alleles and genotypes. And the risk for AT-DILI during TB treatment is low. Expanding such studies with additional markers and larger sample sizes will be useful to generate precise population-specific pharmacogenomics details for efficient TB management.
Haemoglobinopathies are a major health problem worldwide. Because of the high prevalence of these disorders in India and especially in North-East, we undertook this limited student based study as RIMS comprised students from the seven North-East states of Arunachal Pradesh, Manipur, Meghalaya, Mizoram, Nagaland, Sikkim and Tripura. AIMS: To study the prevalence of haemoglobin variants among the North-East students of RIMS and to find out any abnormal haemoglobin pattern pertaining to a particular community. MATERIAL AND METHODS:The present study was carried out in the Department of Pathology, RIMS. From Sept. 2002 to Dec. 2004, our study included 100 student volunteers taking a minimum of ten from each of the seven states. History of presenting complaints, personal, family and past illness were taken. Physical examination was done with special emphasis on appearance, presence of pallor, jaundice and hepatosplenomegaly etc. Blood samples were collected in 2 EDTA vials, one was used for CBC and another for preparation of hemolysate. CBC was done for all cases by electronic cell counter supported by manual hemocytometry, peripheral blood examination and reticulocyte count. All the cases were routinely screened for haemoglobin type using standard alkaline cellulose acetate electrophoresis with Tris-Ethylene Diamine Tetra Acetic Acid (EDTA) borate buffer. Fetal Hb. estimation, sickling test, serum bilirubin estimation were also done in relevant cases. RESULTS: Out of the 100 student volunteers studied, 98 cases showed HbA pattern in 46 males and 52 females while HbE was seen in 2 cases, 1 male and a female. The prevalence of HbE was 2% in our study, which belonged to the ethnic group of Garo of Meghalaya. Both case had mild anemia with microcytosis and normal reticulocyte count. Peripheral smear showed anisopoikilocytosis and target cells. RBC count, MCH values were within normal range. CONCLUSION: Our study showed that HbA was the predominant haemoglobin type amongst the North-East students of RIMS. HbE was also prevalent amongst these students and common among the mongoloid group of Garo with an incidence of 2%. As this study is limited student volunteer based, it cannot represent any community/population. It emphasises the need for further studies with a larger sample involving many communities of different ethnic groups to support the above findings before drawing a conclusion. HOW TO CITE THIS ARTICLE:
A large degenerated fibroid may give a false impression of other abdominal gynecological abnormalities like in our case of a 46-year-old para 3, living 3 (P3L3) woman presented to our hospital with the complaint of distension of abdomen since last ten years. The increase in the size of the abdomen was slow initially, but it increased rapidly in last one month. She complained of right abdominal pain for the last one month along with difficulty in breathing and constipation. Abdomen examination revealed a huge abdominopelvic mass and a provisional diagnosis of the ovarian cyst was made clinically. Computed tomography (CT) scan showed a very large cystic lesion arising from the pelvis filling up the abdominal cavity. We planned for laparotomy and proceed. Intraoperatively, a giant cyst occupying the whole abdomen identified and control suction done with removal of ~5 liters of straw-colored fluid. The cyst was found to have adhered to the mesentery and also attached to the fundal area of the uterus. The cyst was severed from the uterus by clamping and cutting the pedicle of the cyst. Uterus and bilateral ovaries were looking normal. Total abdominal hysterectomy with bilateral salpingo-oophorectomy done. Cyst separated from guts and excised. Feeding vessels were from the mesenteric artery. Histopathological examination showed the features of leiomyoma with cystic degeneration. Leiomyoma with cystic degeneration is the rare secondary changes. But they can cause a diagnostic dilemma by mimicking huge ovarian cyst.
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