Pandey Pinki; Dixit Alok; Aggarwal Ranjan; Mahajan Nanak Chand
Abstract
Background and Objectives: Fine needle aspiration cytology (FNAC) is an established out- patient procedure used in primary diagnosis of palpable thyroid lesions. A modified technique fine needle capillary sampling (FNCS) obviates the need of suction, is less painful, patient friendly and reported to ...
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Background and Objectives: Fine needle aspiration cytology (FNAC) is an established out- patient procedure used in primary diagnosis of palpable thyroid lesions. A modified technique fine needle capillary sampling (FNCS) obviates the need of suction, is less painful, patient friendly and reported to overcome the problem of inadequate and bloody specimens. The aim of our study was to compare the efficacy and quality of FNCS with that of conventional FNAC in the lesions of thyroid. Methods: One hundred patients, presenting between January 2011 to December 2012 at Cytopathology Department of M M Institute of Medical Sciences and Research, Mullana, with diffuse and nodular thyroid lesions were enrolled with both the techniques being executed on the patients, beginning with FNA followed by FNCS. The smears were scored using five objective parameters i.e. background blood, cellular material, cellular degeneration, cellular trauma, and retention of appropriate architecture, in a single blind setting by a cyto-pathologist. The results were analyzed using Student’s test for paired data and chi- square analysis. Results: A highly significant differences (P<0.001) in favor of FNCS was observed for the background blood, cellular material and retention of architecture while total score favored FNA for cellular degeneration and degree of cellular trauma. Total scores and average score per case for FNCS was significantly better (P<0.001) than FNA. FNCS technique yielded more diagnostically superior and lesser number of unsatisfactory smears whereas greater number of diagnostically adequate samples was obtained by FNA technique. Conclusion: FNCS offers more number of diagnostically better quality smears. Both techniques could be supplementary on many occasions and substitutive on a few. Combination of the two techniques could offer better diagnostic accuracy.
Arijit Majumdar; Angshuman Jana; Soumali Biswas; Swagata Bhattacharyya; Anirban Jana
Volume 9, Issue 3 , July 2014, , Pages 193-198
Abstract
Background and Objective: Fine needle aspiration cytology (FNAC) is well accepted as a useful diagnostic technique in the management of adult patients with head and neck lumps. But, until recently, very few reports have been obtained regarding the role of FNAC in nonthyroidal neck masses in children. ...
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Background and Objective: Fine needle aspiration cytology (FNAC) is well accepted as a useful diagnostic technique in the management of adult patients with head and neck lumps. But, until recently, very few reports have been obtained regarding the role of FNAC in nonthyroidal neck masses in children. Hence, the objective of our study was to determine the diagnostic value of fine needle aspiration cytology in the diagnosis of paediatric nonthyroidalneck masses.
Methods: This descriptive study was conducted at the Department of Pathology,Dr.BCRoyPGIPSKolkata from January2012 to December 2012. Hundred patients with non-thyroidal neck masses fulfilling theinclusion criteria were included in the study. Fine needle aspirations were performed by Leishman-Giemsa staining.
Results: The most common nonneoplastic neck swelling seen in children were an enlarged lymph node due to inflammation 38(42.2%),i.e., reactive lymphadenitis. Others were TB lymphadenitis25(27.8%), nonTB granulomatous lymphadenitis 2(2.22%), chr.sialadenitis 2(2.22%), branchial cyst 4(4.44%) and epidermal cyst 3(3.33%) cases.
Overall sensitivity, specificity, positive predictive value and negative predictive value of FNAC in our cases are 93.06%, 72.22%, 93.06% and 72.22%.
Conclusion:FNA is a valuable diagnostic tool in the management of children with the clinical presentation of a suspicious neck mass. The technique reduces the need for more invasive and costly procedures like open biopsy.
Mitra Mustaphi Ruplekha; Gon Sonia; Bhattacharyya Roop Narayan
Volume 9, Issue 1 , January 2014, , Pages 1-8
Abstract
Background & Objective: Chronic non healing ulcers or scar undergoing malignant transformation is a rare phenomenon with an estimated incidence of 2%. Though, numerous predisposing factors have been identified, still it is rarely diagnosed and commonly mistaken for a benign condition. The ...
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Background & Objective: Chronic non healing ulcers or scar undergoing malignant transformation is a rare phenomenon with an estimated incidence of 2%. Though, numerous predisposing factors have been identified, still it is rarely diagnosed and commonly mistaken for a benign condition. The objective of this study was to verify the efficacy of the Fine Needle Aspiration Cytology/ Scrape cytology of chronic non healing ulcers, and its use in the early detection of the malignant transformation, thereby facilitating early management. Methods: A total of 10 cases of chronic non healing ulcer with malignant transformation were included in the study where the initial diagnosis was made on Fine Needle Aspiration Cytology/Scrape cytology and later on confirmed on histopathology. Results: Squamous cell carcinoma (7 cases), acantholytic variant of Squamous Cell Carcinoma (1 case), malignant fibrous histiocytoma (1 case) and carcinosarcoma (1 case) was seen. A 100% concordance with histopathology was seen in Squamous cell carcinoma cases. Because of the rarity of the case and unusual transformation, high grade pleomorphic spindle cell carcinoma was the cytological diagnosis in case of Malignant Fibrous Histiocytoma. Conclusion: Marjolin ulcer arising out of chronic non healing ulcers can prove to be a precursor of any different kind of malignancies. Fine Needle Aspiration Cytology/scrape cytology can be used as a first line diagnostic modality for the early diagnosis as it is a fast and safe method with high rate of accuracy, sensitivity and specificity
Nayereh Ghomian; Sakineh Amouian; Fatemeh Tavassoli; Taraneh Arbabzadeh
Volume 9, Issue 1 , January 2014, , Pages 9-16
Abstract
Background & Objective: Chronic non healing ulcers or scar undergoing malignant transformation is a rare phenomenon with an estimated incidence of 2%. Though, numerous predisposing factors have been identified, still it is rarely diagnosed and commonly mistaken for a benign condition. The objective ...
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Background & Objective: Chronic non healing ulcers or scar undergoing malignant transformation is a rare phenomenon with an estimated incidence of 2%. Though, numerous predisposing factors have been identified, still it is rarely diagnosed and commonly mistaken for a benign condition. The objective of this study was to verify the efficacy of the Fine Needle Aspiration Cytology/ Scrape cytology of chronic non healing ulcers, and its use in the early detection of the malignant transformation, thereby facilitating early management. Methods: A total of 10 cases of chronic non healing ulcer with malignant transformation were included in the study where the initial diagnosis was made on Fine Needle Aspiration Cytology/Scrape cytology and later on confirmed on histopathology. Results: Squamous cell carcinoma (7 cases), acantholytic variant of Squamous Cell Carcinoma (1 case), malignant fibrous histiocytoma (1 case) and carcinosarcoma (1 case) was seen. A 100% concordance with histopathology was seen in Squamous cell carcinoma cases. Because of the rarity of the case and unusual transformation, high grade pleomorphic spindle cell carcinoma was the cytological diagnosis in case of Malignant Fibrous Histiocytoma. Conclusion: Marjolin ulcer arising out of chronic non healing ulcers can prove to be a precursor of any different kind of malignancies. Fine Needle Aspiration Cytology/scrape cytology can be used as a first line diagnostic modality for the early diagnosis as it is a fast and safe method with high rate of accuracy, sensitivity and specificity.
Mahesh Kumar; Ratnakar Potekar; Balasaheb Ramling Yelikar; Vijayalaxmi Patil; Mahesh Karigoudar; Pankaj Pande
Volume 8, Issue 4 , October 2013, , Pages 219-226
Abstract
Background and Objectives: Thyroid gland because of its superficial location is amenable to direct physical examination. Clinical assessment of thyroid lesions by means of physical examination, thyroid scans and ultrasonography is not completely reliable. Fine needle aspiration cytology (FNAC) is the ...
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Background and Objectives: Thyroid gland because of its superficial location is amenable to direct physical examination. Clinical assessment of thyroid lesions by means of physical examination, thyroid scans and ultrasonography is not completely reliable. Fine needle aspiration cytology (FNAC) is the most cost-effective, safe and an initial diagnostic test in the pre-operative evaluation of thyroid lesions. Many surgeons use intraoperative frozen section biopsies to confirm the diagnosis of FNAC and guide the extent of thyroidectomy. Therefore, the objective of the present study was to assess the diagnostic accuracy of frozen section in comparison with fine needle aspiration cytology and histopathology in thyroid lesions.
Materials & Methods: Fine needle aspiration cytology and frozen section (FS) were evaluated in 59 patients. FNAC was classified as benign, malignant and suspicious, and FS was classified as benign, deferred and malignant. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated for both FS and FNAC.
Results: Out of 59 patients, 3 were positive for malignancy, 51 were benign, and five were suspicious on FNAC. Over all accuracy of fine needle aspiration cytology was 93%. Five were positive for malignancy, 50 were benign and 4 were “deferred” in frozen section. Over all accuracy of frozen section was 96%.
Discussion: Fine needle aspiration cytology can be used primarily to select patient for surgery and frozen section can be employed to plan the extent of surgery. Frozen section had a good accuracy, sensitivity and negative predictive value compared to fine needle aspiration cytology.
Nisha Marwah; Shweta Rana; Promil Jain; Sumiti Gupta; Sanjay Marwah; Rajeev Sen
Volume 8, Issue 2 , April 2013, , Pages 97-103
Abstract
Background & Objective: Abdominal cutaneous and subcutaneous nodules are uncommon lesions which may be benign or malignant. Majority of the malignant nodules are metastatic in origin and may be the initial presentation of primary malignancy, hence an early diagnosis is important. Our aim was to find ...
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Background & Objective: Abdominal cutaneous and subcutaneous nodules are uncommon lesions which may be benign or malignant. Majority of the malignant nodules are metastatic in origin and may be the initial presentation of primary malignancy, hence an early diagnosis is important. Our aim was to find out the spectrum of lesions (both non-neoplastic and neoplastic) that present as cutaneous and subcutaneous abdominal wall nodules and to assess the efficacy of fine needle aspiration cytology (FNAC) in early diagnosis of all such lesions so that need for histopathology can be minimized. Material and Methods: The study was conducted on 46 patients of all age groups, presenting with various palpable cutaneous and subcutaneous abdominal wall nodules. FNAC was performed, smears stained with May Grunwald- Giemsa stain and Pap stains. Special stains were applied wherever required. Cytological diagnosis was subsequently correlated with histopathological diagnosis. Results: Out of 46 FNAC cases ; there were 13 non-neoplastic lesions, 15 benign neoplasms and 17 malignant lesions. One case was inadequate for opinion that on histopathology turned out to be metastatic deposits from renal cell carcinoma. The rate of unsatisfactory FNAC was 2.2% and the sensitivity was 89.47%. The specificity and positive predictive value was 100%. Conclusion: FNAC is a simple, minimally invasive, highly accurate and cost effective technique for quick diagnosis of malignant metastatic abdominal wall nodules, thus minimising the need for histopathology and for deciding mode of treatment.
Fahimeh Asadi Amoli; Ali Sadeghi Tarri; Khalil Hamzeh Doost; Naser Kamalian; Hedieh Moradi Tabriz
Volume 6, Issue 3 , June 2011, , Pages 124-132
Abstract
Background and Objectives: We aimed at evaluating the efficacy of fine needle aspiration biopsy (FNA) in comparison with histopathology and demonstrating whether cytological study could be a proper diagnostic tool in orbital mass lesions. Materials and Methods: In a cross sectional study during 36 months, ...
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Background and Objectives: We aimed at evaluating the efficacy of fine needle aspiration biopsy (FNA) in comparison with histopathology and demonstrating whether cytological study could be a proper diagnostic tool in orbital mass lesions. Materials and Methods: In a cross sectional study during 36 months, patients referred to our ophthalmologic center affiliated to Tehran University of Medical Sciences, for evaluation of orbital masses, were selected for FNA. After the surgery, the results of FNA were compared against histopathologic diagnoses as our gold standard method. Finally, the frequencies of specimen adequacy, the accuracy of FNA in distinguishing benign and malignant lesions and in the exact definitive diagnosis of the disorders were reported. Results: In 27.4% of the total 62 cases, the specimens were inadequate for cytologic evaluations. The rate of specimen adequacy in malignant and benign lesions was 82.6 % and 66.66%, respectively. From the morphologic point of view, the rate of the exact definitive diagnosis of malignant and benign disorders in the total 62 cases was 78.2% and 38.46% and; in the adequate specimens, it was 94.73% and 57.69%, respectively. There was no false positive FNA result for malignant cells and only in one malignant case, the FNA report was falsely negative. All data wee analyzed by SPSS software and p value Conclusion: FNA was considered more beneficial in the diagnosis of malignant lesions. FNA is a relatively noninvasive, rapid, specific, and accurate method for the preoperative primary diagnosis of orbital mass lesions and especially in malignant lesions and in some conditions, specific diagnoses can be achieved.
Mohammad Rakhshan; Azadeh Rakhshan
Volume 4, Issue 4 , September 2009, , Pages 147-150
Abstract
Background and Objective: Fine needle aspiration cytology (FNAC) is a well-established method of diagnosis in palpable masses of various sites. This study was conducted to evaluate the usefulness of FNAC as a diagnostic tool in the management of patients with cervical lymphadenopathy. Patients and Methods: ...
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Background and Objective: Fine needle aspiration cytology (FNAC) is a well-established method of diagnosis in palpable masses of various sites. This study was conducted to evaluate the usefulness of FNAC as a diagnostic tool in the management of patients with cervical lymphadenopathy. Patients and Methods: Totally 178 patients admitted to Loghman-Hakim Hospital , Tehran, Iran, with cervical masses, were included in this study. They had undergone FNA and subsequently excisional biopsy of the same neck mass in which a lymphoid tissue lesion had been established. Results: Reactive lymphadenitis, metastatic neoplasm, Hodgkin’s lymphoma, and non-Hodgkin’s lymphoma constituted 59.6%, 17.9%, 14.6% and 7.8% of total cases, respectively. In 27 cases (15.2%), the FNA findings were nondiagnostic. Diagnostic accuracy of FNAC was about 88%. Sensitivity, specificity, positive and negative predictive values were 75.8%, 96.6%, 94% and 85.1%, respectively. Conclusion: FNAC has a high accuracy in the diagnosis of malignancies of cervical lymph nodes, but due to the existance of false negative cases, the benign results should be further evaluated if high clinical suspicion of malignancy exists.
Farid Kosari; Hedieh Moradi Tabriz; Sanaz Saniee
Volume 4, Issue 4 , September 2009, , Pages 186-189
Abstract
In Riedel’s thyroiditis, a rare chronic inflammatory disease of thyroid gland, fine needle aspiration is usually non-diagnostic because most often only follicular cells are obtained and not the fibrous material characteristic of this type of thyroiditis. Therefore the diagnosis is often only established ...
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In Riedel’s thyroiditis, a rare chronic inflammatory disease of thyroid gland, fine needle aspiration is usually non-diagnostic because most often only follicular cells are obtained and not the fibrous material characteristic of this type of thyroiditis. Therefore the diagnosis is often only established by histopathologic study of the surgically obtained biopsy. The illustrated case is a 46-year-old female who presented with a firm, non-mobile thyroid nodule of the left lobe. Fine needle aspiration was performed, demonstrating fragments of fibrous tissue and few inflammatory cells including neutrophils and lymphocytes, findings that could be representative of Riedel’s thyroiditis. Frozen section examination during subsequent surgery and later histopathologic study confirmed the diagnosis. Fine needle aspiration of the thyroid, if successfully done, could be highly suggestive for Riedel’s thyroiditis.
