Development of a malignant tumor is a well known complication of a chronic burn scar. Most of these tumors are squamous cell carcinomas and only 28 cases of burn scar sarcomas have been reported in literature. We report the first occurrence of the combination of squamous cell carcinoma and epithelioid sarcoma arising in a burn scar.
Background: An encouragement for the thyroid proposal was the Bethesda system for reporting cervical cytology interpretations, a uniform reporting system for thyroid FNA will facilitate effective communication among health care providers. The objective of the present study was to classify thyroid lesions in various categories under Bethesda system correlating the cytological findings in various thyroid lesions with clinical and radiological details.Methods: A retrospective study on FNAC thyroid was performed in a tertiary hospital and a Medical teaching institution in Mumbai, Maharashtra, India which included cases which were reported from 1st January 2010 to 31st July 2011. For cytomorphological analysis, all smears (Papanicolaou and MGG) were reviewed and cases were categorized into six Bethesda categories. The FNAC findings were correlated with clinical, radiological and laboratory findings. Discrepancies between original diagnosis and review diagnosis as well as difficulties encountered during application of Bethesda were studied in detail.Results: Total 413 FNACs were received during the study period. The original diagnoses included 10 different categories or labels some of which were descriptive. On application of Bethesda, maximum cases were found in category II (82.32%) followed by category I i.e. inadequate (7.7%). Category III (Atypia of Undetermined significance) included wide spectrum of cases which were previously diagnosed as goitre, suspicious or neoplastic.Conclusions: Bethesda system of reporting thyroid FNAC has brought uniformity in cytology reporting. It has facilitated better understanding between cytopathologist and clinicians as every category connotes specific risk of malignancy and recommends treatment.
Background:To utilise an autopsy-based approach to study the febrile deaths and deaths due to malaria during monsoon period of three years at a tertiary care teaching hospital in Mumbai, India.Materials and Methods:All autopsies done at the hospital during monsoon period from 2005 to 2007 when fever was the main presenting symptom were included in the study. Monsoon period was defined from June to September. A study on the duration of hospital stay of malaria deaths was also attempted.Results:There were 202 autopsies of febrile illness during the study period. Malaria resulted in 20.8% of the deaths besides other causes. A majority of deaths had intrapulmonary haemorrhages as the only pathological finding. Incidence of malaria deaths was more during monsoon period than the non-monsoon period. Plasmodium falciparum was the most common species responsible for malaria deaths while cerebral malaria was the most common mode of death. In 27% of the cases, post-mortem examination helped to arrive at the correct final diagnosis. In 88.1% of the cases, malaria deaths occurred within the first 24 hours of admission to the hospital.Conclusion:The study reiterates the fact that malaria remains a preventable but major cause of death in India, predominantly during the monsoon period. The study also emphasises the importance of developing treatment protocols for malaria during such crucial times besides reinforcing the existing preventive measures.
The typical sonomorphology of homogeneously hypoechoic texture of an enlarged parathyroid gland (PG) is a reflection of uniform arrangement of the parathormone-producing chief cells. A variable cellular arrangement, hemorrhage, fibrosis, and adipocytes cause heterogeneous appearance. We describe a case of a 32-year-old male, a case of tertiary hyperparathyroidism, with increased serum parathormone levels, hypercalcemia, and enlargement of all four PGs, albeit with differing morphology. The left lower gland had two nodules, namely, superior and inferior. The inferior nodule of the left lower gland had an echogenic core surrounded by a sonolucent rim whereas the superior nodule was homogenously hyoechoic. The left upper gland had an echopattern exactly reverse of the inferior nodule of the left lower PG, i.e., hypoechoic gland surrounded by hyperechoic periphery. The appearance of the right-sided glands was that of the superior nodule of the left lower PG. On histopathology, the hypoechoic areas corresponded to numerous chief cells and congested vessels whereas edema gave rise to an increase in echogenicity. This report exemplifies atypical sonographic appearances of PG and their histopathologic correlation.
FNAC though considered the gold standard diagnostic test in the evaluation of a thyroid nodule, has many issues regarding the terminologies and interpretation. The National Cancer Institute (NCI) hosted the NCI Thyroid Fine needle Aspiration State of the Science Conference in 2007, which acknowledged the importance of developing a uniform terminology for reporting thyroid FNA results to facilitate effective communication among cytopathologists, endocrinologist, surgeons, radiologists and other healthcare providers. The NCI Conference concluded the terminology and morphologic criteria which formed the framework for The Bethesda system for reporting thyroid cyto pathology (TBSRTC). It is a 6 tiered 'The Bethesda System for Reporting Thyroid Cytopathology' (TBSRTC) for unifying the terminology and morphologic criteria along with the corresponding risk of malignancy. Bethesda also offers manage ment approach for all the categories. Bethesda system is presently widely accepted in western countries and is being introduced in rest of the world. This system of reporting undoubtedly represents a major step toward standardization, reproducibility and ultimately improvement in clinical signi ficance, usefulness and predictive value of thyroid FNAC. The problems faced by the cytopathologist while implementing Bethesda during reporting are centred on AUS/FLUS category. The heterogeneity of this low-risk category leads to significant variability in its reported percentage as well as reported rate of malignancy.
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