Background: The extrapulmonary tuberculosis (EPTB) is challenging to diagnose due to its pauci-bacillary nature. According to recent research, WHO recommends cartridge based nucleic acid amplification test (CBNAAT) to be used as initial diagnostic test in suspected cases of extrapulmonary tuberculosis. Aim of the present study is to assess the role of CBNAAT in comparison with cytomorphological features upon fine needle aspiration cytology (FNAC) and Ziehl-Neelson (ZN) stain in clinically suspected cases of EPTB.Methods: Present pilot study is descriptive cross-sectional study of 439 cases of clinically suspected EPTB over a period of 12 months (January 2019 to December 2019). After procedure of fine needle aspirates, smears were stained with routine H&E, papanicolaou stain and ZN stain. In the same setting, aspirate was also sent for CBNAAT. Results were obtained after detailed study.Results: Out of 439 cases, presumptive tuberculosis was diagnosed in 192 cases showing either epithelioid cell granulomas or caseous necrosis or both upon morphology, while overall 94 cases were positive on ZN stain and 146 cases were CBNAAT positive with the sensitivity of 84.04% and specificity of 80.57%.Conclusions: FNAC is the cheapest and simplest method to diagnose extrapulmonary tuberculosis, however those smears where tuberculosis cannot be diagnosed on FNAC like suppurative lesions, reactive lymphadenitis and low cellularity, CBNAAT plays a key role for the correct diagnosis thereby significantly reducing the morbidity and mortality.
Actinomycosis is a chronic infection caused by Actinomyces israelii, usually seen in immunocompromised patients or in the background of tissue injury. Vulvar actinomycosis presenting as a fixed swelling in an elderly individual can mimic malignancy and pose a diagnostic dilemma. We report here a case of vulvar actinomycosis diagnosed by fine needle aspiration (FNA). A 60-year-old postmenopausal female presented with a gradually increasing 15 cm × 10 cm vulvar swelling involving the right mons and right labia majora. The swelling was nodular, fixed, and nonulcerated, with multiple healed and few active discharging sinus tracts draining serosanguineous fluid and yellowish sulfur granules. FNA was diagnostic, as it revealed colonies of Actinomyces surrounded by polymorphs. Histopathology of excised specimen confirmed the cytological findings. FNA is an effective tool in the diagnosis of actinomycosis, although, its documentation is rare. Difficulties in the management can be avoided by early diagnosis using the FNA technique.
Background: Nasal and sinonasal lesions comprise common as well as rarest rare lesions. This region being a site of histopathologically diverse lesions, interests pathologists. Objectives: The study aimed to find out incidence of nasal and sinonasal lesion with frequency of non-neoplastic, neoplastic lesions, to study spectrum of lesions histopathologically along with correlation of clinical and radiology findings. Material and methods: It was a 2 year retrospective observational study involving 102 cases from January 2012 to December 2013 carried out at Government medical college, Nagpur. Study included all specimens received as nasal and sinonasal lesions. Complete clinical history and radiological findings were correlated with histopathology findings. Results: Nasal and sinonasal lesions are rare having 1.07 % incidence rate. Majority of patients of nonneoplastic and benign neoplastic category belonged to 11-20 age group while malignancies were common in 41-50 age group. We encountered more neoplastic lesions (53.92%) compared to nonneoplastic lesion (46.08%). Male to female ratio was 1.5:1. Sensitivity, specificity and diagnostic accuracy of clinical diagnosis was 94.73%, 97.67 % and 96 % respectively while positive predictive value and negative predictive value was 98.18 % and 93.33 %. p value was 0.317. Discordance in clinic-histopathological diagnosis was in 5.88 % Conclusion: Though there was good correlation between clinicoradiology findings and histopathology, however in 5.88% discordant cases histopathology diagnosis led to significant alteration of treatment plan proving key role of histopathology diagnosis. Keywords: Benign, Central India, Clinicohistopathology, Profile, Malignant, Nasal, Sinonasal.
Breast lesions are leading cause of morbidity and mortality in women worldwide. Fine Needle Aspiration (FNA) is an affordable, minimally invasive and rapid method. It is gaining importance as a preoperative procedure to distinguish benign and malignant breast lesions. Thus unnecessary invasive procedures can be avoided. This study is undertaken to explore utility and accuracy of FNA in various breast pathologies.Objectives: 1) To study cytology of various breast lesions, 2) To correlate cytological diagnosis with histopathological diagnosis wherever possible, 3) To study sensitivity, specificity and accuracy of FNA in breast lesions Materials and Methods: A two year prospective study was carried out from November 2017 to November 2019 at Department of Pathology, JJM Medical College -Davangere. This study included patients with breast lesions referred for FNA. FNA was done. Cytomorphological features were studied. Cytomorphological diagnosis was correlated with histopathological diagnosis wherever possible. Results: Out of 425 patients with suspected breast lesions, cyto-histo morphological correlation was possible in 331 cases. Cytology histology concordance was 94.4%. This study has sensitivity of 90.1%, specificity of 96.5% and accuracy of 94.1%. Conclusion: FNA is highly simple, safe and effective technique. It should be an essential component in preoperative diagnosis of breast lesions.
Introduction: Carcinoma of cervix is the most common cancer in Indian women and is the third largest cause of cancer mortality in India. The transformation zone of the cervix is vulnerable to HPV. A preneoplastic cervical intraepithelial neoplasia can regress, persist or progress towards invasive carcinoma. Aims: To study the prevalence and histopathological spectrum of premalignant and malignant lesions of uterine cervix. Methods: This was a retrospective cross-sectional study, carried out at Tertiary Care Hospital, in Department of Pathology, over a period of one-year. Results:Total 14 cases (8%) of total hysterectomy and 156 cases (92%) of cervical biopsy were included, which included31 cases (18%) premalignant lesions (CIN-I, II, III, CIS) and 139 cases (82%) malignant. SCC was found in 73% cases and adenocarcinoma in 8.3%. Limitations: Follow-up was not possible. Conclusions: Awareness programs and educational sessions might help to reduce the burden of carcinoma cervix in India.
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