Deficiency of vitamin B12 due to nutritional insufficiency is common in developing part of world. Serum vitamin B12 level in infants is determined by the foetal storage during pregnancy. Therefore, evaluation on vitamin B12 level during pregnancy is essential for prevention of vitamin B12 deficiency in infancy. Here we report a vitamin B12 deficient infant who presented with hepatosplenomegaly with pancytopenia including normocytic anaemia and circulating atypical cells. It is also a reminder to clinicians about the uncommon manifestation of vitamin B12 deficiency which mimics haematological malignancy.
Background: Fine needle aspiration cytology and core needle biopsy are reliable procedures for breast cancer detection. Core needle biopsy is an established alternative to surgical biopsy for diagnosis and prognostication. However, there may be a concern that core needle biopsy may be less reliable than excisional biopsy. The aim of this study was to compare the cytological/core needle biopsy finding with excisional histopathological diagnosis and determine their hormonal status. Materials and Methods: A prospective study of 65 patients was conducted after obtaining a detailed clinical data. The comparison of the fine needle aspiration cytology/core needle biopsy finding with excisional histopathological diagnosis of breast malignancy was carried out after data analysis. Their ER, PR and HER-2/neu status was also studied in available cases. Results: Out of the 65 cases of breast malignancy, 69.2% of cases had undergone fine needle aspiration, 60% cases core needle biopsy and 93.8% cases excisional biopsy. The most common carcinoma was invasive carcinoma of no special type. The diagnostic accuracy of fine needle aspiration and core needle biopsy was almost equal, however, core needle biopsy could assess the histological typing and biomarker status. The hormonal status was assessed in 69.23% cases, among them 35.6% cases were triple negative carcinomas. Conclusions: Core needle biopsy was superior to fine needle aspiration cytology in the diagnosis of breast lesions in terms of diagnostic accuracy. Thus, our result provides valuable prognostic information to guide the decision-making process for the treatment of a patient with invasive carcinoma.
Introduction: Cervical region is the commonest area of lymphadenopathy which is easily accessible to ultrasound and Doppler study. The morphological and vascular-architectural differences among various nodal diseases aids in differentiating benign from malignant causes. Methods: The study was done on the 108 patients referred to Department of Radiology andImaging, TUTH for ultrasound of cervical lymphadenopathy who subsequently underwentFNAC examination. Gray scale evaluation for morphology of the nodes along with Doppler evaluation for resistive index (RI), pulsatility index (PI) and Peak systolic velocity (PSV) were done and correlated with FNAC findings. Results: Among the 108 lymph nodes, 24 were proven to be malignant on FNAC. Features such as S/L ratio >0.5, absence of echogenic hilum, and abnormal vascular pattern demonstrated sensitivities of 96%, 92%, and 87%, specificities of 74%, 65% and 77% and positive predictive values (PPVs) of 51%, 43%, and 55% respectively. The cutoff values for RI, PI and PSV were found to be 0.705, 1.34 and 17.5 cm/s with sensitivities of 96%, 96% and 87%, specificities of 95%, 99% and 88% and positive predictive values (PPVs) of 85%, 95% and 70% respectively. Conclusion: Ultrasound findings of S/L ratio, absence of echogenic hilum, abnormal vascular pattern and Doppler indices revealed good sensitivity, specificity, and accuracy in differentiating benign and malignant lymph nodes.
Castleman disease (CD) is a group of lymphoproliferative disorders with common lymph node histological features. It may be either unicentric or multicentric. Unicentric Castleman disease (UCD) is localized and carries an excellent prognosis, whereas multicentric Castleman disease (MCD) is a systemic disease occurring most commonly in the setting of HIV infection and is associated with human herpesvirus 8.1Castleman disease in the abdomen and pelvis is rare and liable to misdiagnosis, but its characteristic imaging features can help in the diagnosis and differential diagnosis.2Unicentric Castleman disease (UCD) is rare, and there are no reliable estimates of its incidence in the population. While UCD can occur at any age, it is generally a disease of younger adults. The median age at presentation is approximately 35 years.3, 4
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