Diagnostic Pathology
Sweta Kamalkant Shastri; Archana Joshi
Abstract
Background & Objective: Modified Ultra-fast Papanicolaou (MUFP) stain has been developed from Papanicolaou stain (PAP) with the goal to improve staining quality, minimize staining time for obtaining immediate cytological diagnosis and to check specimen adequacy during Ultrasound guided Fine needle ...
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Background & Objective: Modified Ultra-fast Papanicolaou (MUFP) stain has been developed from Papanicolaou stain (PAP) with the goal to improve staining quality, minimize staining time for obtaining immediate cytological diagnosis and to check specimen adequacy during Ultrasound guided Fine needle Aspiration Cytology (US guided FNAC). The aim of this research was to study the cytomorphological features of intra-abdominal lesions with help of US guided FNAC and to assess the diagnostic utility of Modified Ultrafast Papanicolaou stain in cytological diagnosis. Methods: This cross-sectional study enrolled consecutive 100 subjects in N.K.P Salve Institute of Medical Sciences and Research Centre, Nagpur, which is a tertiary teaching hospital in India, from July 2015 to June 2017 who underwent US guided FNAC for Intra-abdominal lesions. Fine needle aspiration was done under ultrasound guidance and the smears were divided into two groups. Wet smears were fixed in 95% ethyl alcohol for conventional PAP staining and air dried for MUFP. After staining, results were evaluated on basis of the cytological features. Scores were given according to four parameters namely background of smears, staining pattern, cell morphology and nuclear staining. Quality index was calculated from the ratio of score achieved to the possible maximum score. Result: The most common organs involved were ovaries (46 %) followed by liver (11%) and most common lesions were malignant (68 %). The cytological characteristic showed significant difference in all four parameters (P<0.05) when MUFP stain smears were compared with PAP stain smears. There was also statistically significant difference when cumulative score and Quality Index were compared (P<0.001) between the two stains. Conclusion: The US guided Fine needle aspiration (FNA) is simple, safe, rapid and inexpensive technique useful in cytological diagnosis. MUFP stain is fast, reliable and has better diagnostic utility for cytological diagnosis when compared to PAP stain.
Pranjali Sejwal; Milan Jaiswal; Surbhi Pandey
Volume 13, Issue 3 , July 2018, , Pages 340-347
Abstract
Background and Objective:The current study aimed at observing the cytomorphological patterns in patients presenting with enlarged cervical lymphnodes, diagnosed by fine needle aspiration cytology (FNAC), their distribution with respect to age and gender, and determining the accuracy of FNAC as a diagnostic ...
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Background and Objective:The current study aimed at observing the cytomorphological patterns in patients presenting with enlarged cervical lymphnodes, diagnosed by fine needle aspiration cytology (FNAC), their distribution with respect to age and gender, and determining the accuracy of FNAC as a diagnostic procedure incases with cervical lymphadenopathy.Methods: Out of all patients presenting with cervical lymphadenopathy from September 2015 to September 2016, in the Department of Pathology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India 100 consecutivecases were enrolled into the current study, following the exclusion of all cases where FNAC smears were inadequate or suboptimal for diagnostic interpretation. Histopathological examination was conducted on small excision biopsy specimens/radical neck dissection, where ever possible and diagnostic efficacy of FNACwas evaluated. Results: Theoverall age range of the enrolled patients, presentingwith enlarged cervical lymph nodes, was 1-72 years withthe mean age of 35.7 years and male-femaleratio of 1.6:1.Out of the 100 cases, benign and malignant lesions comprised 77 and 23 cases, respectively.The most common observed benign lesion was reactive hyperplasia(29%), while squamous cell carcinoma was the most common malignant lesion.The overall sensitivity, specificity, positive predictive value, negative predictive value,andthe diagnostic accuracy was 100%, 91.67%, 92%, 100%, and 95.7%, respectively.Conclusion: FNAC in the diagnoses of inflammatory and neoplastic diseases serves as a reliable,low-cost, rapid diagnostic tool with reasonably good accuracy that caninfluence patient management in terms of early diagnoses, treatment, and prevention of unnecessary surgery in patients.
Sourav Bhowmik; Indranil Chakrabarti; Piyali Ghosh; Pranati Bera; Tarak Banik
Abstract
Background& Objective: Fine needle aspiration cytology (FNAC) is an easy, rapid, and less hazardous tool to diagnose the intra-abdominal lesions with various imaging modalities adding to its sensitivity and accuracy. However, sometimes it does not yield adequate information for precise diagnosis ...
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Background& Objective: Fine needle aspiration cytology (FNAC) is an easy, rapid, and less hazardous tool to diagnose the intra-abdominal lesions with various imaging modalities adding to its sensitivity and accuracy. However, sometimes it does not yield adequate information for precise diagnosis and the risk of false-negative and indeterminate diagnosis is always present. Cellblock preparations may be particularly helpful in such problematic cases. The current study aimed at evaluating and comparing the cytological as well as histopathological features of different intra-abdominal mass lesions. Methods: Image-guided FNAC followed by cell block were performed on 167 patients from June 2012 to May 2013. Histologically correlated 111 cases were evaluated. Results of conventional smear, cell block, and combination of FNAC with cell block were compared with histopathological findings regarding diagnostic sensitivity, specificity, and accuracy of diagnosis. Result: Cell block was more specific to diagnose these lesions than FNAC (95.49% versus 90.09%). Combined application of cell block with FNAC was more specific (96.39%) than cell block alone with 100% diagnostic accuracy. Conclusion: Application of a combination of cell block with FNAC was more useful to diagnose intra-abdominal mass lesions.
Oral Pathology
Pooja Jaiswal; Mousumi Sharma; Faraz Ahmad; Nausheen Sanaullah Khan; Siddhartha Sinha; Megha Agarwal
Abstract
Background and objective: Fine needle aspiration cytology (FNAC) of salivary gland lesions is an accepted and useful diagnostic tool to differentiate between benign and malignant lesions. Majority of the neoplasms are benign, and specific diagnosis on cytology can be made in most of the cases. However, ...
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Background and objective: Fine needle aspiration cytology (FNAC) of salivary gland lesions is an accepted and useful diagnostic tool to differentiate between benign and malignant lesions. Majority of the neoplasms are benign, and specific diagnosis on cytology can be made in most of the cases. However, the utility is limited by the overlapping and heterogeneous morphological features of benign and malignant neoplasms. The current study aimed at investigating the cytomorphological features of salivary gland lesions with histopathological correlation and performing risk based stratification of these lesions using the recommended Milan system for reporting of salivary gland cytopathology (MSRSGC). Methods: The current study was conducted on 192 retrospective and prospective cases of salivary gland lesions over a period of three years from October 2014 to September 2017. Cytohistopathological correlation was observed in 62 cases. Subsequently, cytomorphological features were further revaluated, classified according to MSRSGC into six groups, and correlated with clinico-histopathological features. Result: Diagnostic sensitivity and specificity of FNAC for salivary gland lesions was 63.16% and 97.62%, respectively. The positive predictive value was 92.31% and negative predictive value was 85.42%. The diagnostic accuracy to differentiate between benign and malignant lesions was 86.88%.The number of cases in each diagnostic category and the risk of malignancy (ROM) were as follows: nondiagnostic – three cases (ROM – 33.33%), nonneoplastic – 14 cases (ROM – 7.14%), atypical – one case (ROM – 100%), benign – 28 cases (ROM – 7.14%), NUMP – one case (ROM – 100%), suspicious – one case (ROM -100%), and malignant – 13 cases (ROM – 92.30%). Conclusion: Risk based stratification scheme as recommended by MSRSGC can provide a standard method to analyse the results and help to plan the management of salivary gland lesions.