Clinical to Histopathological Correlation of the Diagnosis of Dementia

1991 ◽  
Vol 3 (S1) ◽  
pp. 69-74 ◽  
Author(s):  
I. Alafuzoff ◽  
A.-L. Rönnberg ◽  
S. Asikainen-Gustafsson
Keyword(s):  
Clinical Diagnosis ◽  
Clinical Investigation ◽  
Clinical Signs ◽  
University Hospital ◽  
Vascular Lesions ◽  
Cortical Atrophy ◽  
Histopathological Diagnosis ◽  
Exact Nature ◽  
Histopathological Correlation ◽  
Diagnostic Decision

Between January 1988 and December 1989, 1,600 autopsies were performed at Huddinge University Hospital, representing approximately 40% of the 4,000 deceased patients. In 40% (647) of the autopsy cases, patients showed clinical signs of CNS dysfunction.Of these cases, 58% (380) were subject to neuropathological evaluation, including both macro- and microscopic examination. Only macroscopic examination by general pathologists was performed on the remaining cases. Clinical signs of dementia were seen in 10% (169 cases) of the autopsied patients. Neuropathological evaluations were performed on 70% (118) of these patients. Of these, 60% (70) showed degenerative changes and 36% (43) vascular alterations. Macroscopic examinations alone were performed in 30% of the cases. Of these, signs of severe cortical atrophy were seen in 21%, vascular lesions in 12%, and no macroscopic changes in 67%. The completeness of clinical and postmortem examinations of the 169 demented patients was variable. Approximately 40% of the patients lacked any diagnostic decision. In approximately 50% of the cases with diagnostic decision, the clinical diagnosis correlated with the histopathological diagnosis. This low correlation between the clinical diagnosis and the exact nature of the disease was primarily based on the variable completeness of the clinical examinations. In order to improve this situation, it is important to perform both a complete clinical investigation and a neuropathological verification of the nature of the disease.

scholarly journals Study of glottic lesions in patients undergoing microlaryngeal surgery

2020 ◽  
Vol 6 (2) ◽  
pp. 277
Author(s):  
Vikrant Mittal ◽  
Manish Munjal ◽  
Rohit Verma ◽  
Parth Chopra ◽  
Hemant Chopra
Keyword(s):  
Clinical Diagnosis ◽  
Histopathological Examination ◽  
Detailed Examination ◽  
Histopathological Diagnosis ◽  
Female Ratio ◽  
Histopathological Correlation ◽  
Male Female Ratio ◽  
Male Preponderance ◽  
Vocal Nodules ◽  
Microlaryngeal Surgery

<p class="abstract"><strong>Background:</strong> Vocal cords are the most common site of laryngeal pathologies. Hoarseness is the sentinel symptom for lesions affecting the glottis. The aim of this study was to categorize various types of lesions affecting the glottis in patients undergoing microlaryngeal surgery. Patients’ demographic profile, gender, occupational factors were studied. Clinical, microlaryngeal and histopathological correlation of the lesions was done.</p><p class="abstract"><strong>Methods:</strong> 50 patients with glottic pathologies undergoing microlaryngeal surgery were included. Patients underwent detailed examination including indirect laryngoscopy, flexible fibreoptic laryngoscopy, followed by microscopic laryngeal examination under general anaesthesia. The lesions were excised using standard microlaryngeal instruments and the specimens were subjected to histopathological examination. The data was analysed.  </p><p class="abstract"><strong>Results:</strong> There was male preponderance (male: female ratio of 1.27:1). Housewives formed the largest group (28%). Commonest pathologies were vocal nodules (34%), vocal polyps (22%) and carcinoma (22%). Microlaryngoscopy was found to be the best means of visualizing the lesions and reaching a clinical diagnosis. In 10 (20%) patients, the final histopathological diagnosis was different from clinical diagnosis.</p><p class="abstract"><strong>Conclusions:</strong> In this study, vocal nodules were the commonest lesions to affect the glottis. Microlaryngoscopy proved to be the best method for examination. Also, there was discrepancy in the clinical and histopathological diagnosis in 20% cases.</p>

scholarly journals A Clinico-histopathological Correlation of Elective Abdominal Hysterectomy in University Hospital

2018 ◽  
Vol 1 (2) ◽  
pp. 18-22
Author(s):  
Sarada Duwal Shrestha ◽  
R. Shrestha ◽  
R. Pradhan
Keyword(s):  
Ovarian Tumor ◽  
Preoperative Diagnosis ◽  
Clinical Symptoms ◽  
Abdominal Hysterectomy ◽  
Atypical Hyperplasia ◽  
University Hospital ◽  
Histopathological Diagnosis ◽  
Histopathological Correlation ◽  
Fibroid Polyp ◽  
Chronic Cervicitis

Introduction: The objective of this study was to correlate preoperative indications of abdominal hysterectomy with histopathological findings. Methods: This cross-sectional study was conducted in Patan Hospital from April 2016 to March 2018 in all the patients who underwent elective abdominal hysterectomy. Demographic characteristics, clinical symptoms, preoperative diagnosis and final histopathological diagnosis were studied. Preoperative indications were correlated with histopathological diagnosis. Results: A total of 203 elective abdominal hysterectomies were performed. Menorrhagia was the leading symptom found in 67 (33.00%) patients followed by pain abdomen in 62 (30.54%) patients. Leiomyoma was the most common preoperative diagnosis seen in 105 (51.72%) patients followed by ovarian tumor in 34 (16.75%) patients. The most common histopathological diagnosis was leiomyoma observed in 87 (42.86%) patients followed by ovarian tumor in 35 (17.24%) patients. Clinical and histopathological correlation was 100% in cases of ovarian tumor, complex endometrial atypical hyperplasia, pelvic inflammatory disease (PID), fibroid polyp and chronic cervicitis. Only 40% of preoperatively diagnosed postmenopausal bleeding cases were correlated histopathologically while the rest were missed preoperatively which included endometrial polyp (40%) and adult granulosa cell tumor (20%). Conclusions: Leiomyoma was the most common preoperative and histopathological diagnosis. Clinical and histopathological correlation was 100% in cases of ovarian tumor, complex endometrial atypical hyperplasia, PID, fibroid polyp and chronic cervicitis.

scholarly journals Clinicohistopathological correlation of leprosy

2017 ◽  
Vol 7 (1) ◽  
pp. 1095-1102
Author(s):  
A Shrestha ◽  
S Chauhan ◽  
M Mathur
Keyword(s):  
Clinical Diagnosis ◽  
Clinical Information ◽  
Lepromatous Leprosy ◽  
P Value ◽  
Histopathological Diagnosis ◽  
Histopathological Correlation ◽  
The Social ◽  
Tuberculoid Leprosy

BACKGROUND: Leprosy is a chronic infectious granulomatous disease caused by Mycobacterium leprae. It is a spectral disease which is classified into five groups according to Ridley and Jopling based on clinical, histological, microbiological and immunological criteria. Adequate clinical information combined with bacilloscopy and histopathology is helpful not only in classification of different types of leprosy but also useful for management of the cases.METHOD: 50 cases of leprosy were examined and clinical data was recorded. Slit skin smears were stained with Ziehl Neelsen stain. Skin biopsy was stained with Hematoxylin-Eosin stain and Fite Farraco stain was performed to demonstrate acid fast bacilli. All patients were classified according to Ridley & Jopling classification. Clinico-histopathological correlation was done. Statistical analysis was done using SPSS (Statistical Package for the Social Sciences) 16.0.RESULTS: Most common histological type of leprosy was tuberculoid leprosy seen in 19(38%) cases followed by indeterminate leprosy. Overall clinico-histopathological correlation was seen in 39.58%. The correlation was highest in indeterminate and histoid leprosy (100%) followed by lepromatous leprosy (66.66 %%) and tuberculoid leprosy (50%). Slit skin smear showed bacilli in 12 out of 48 cases (25%) while biopsy showed bacilli in 16 out of 48 cases (33.3%).CONCLUSION: In the present study, clinical diagnosis did not correlate with histopathological diagnosis significantly (p value=0.04159). The study emphasizes the role of histopathological and bacilloscopic examination to aid the clinical diagnosis for accurate typing of leprosy cases then better management of the patient.

scholarly journals Spectrum of Malignant Skin Lesion in Patients attending Nepalgunj Medical College and Teaching Hospital

2017 ◽  
Vol 2 (2) ◽  
pp. 156-161
Author(s):  
Reena Rana ◽  
G P Ghimire ◽  
S Gupta ◽  
M Singh ◽  
KK Jha ◽  
...  
Keyword(s):  
Skin Lesion ◽  
Clinical Diagnosis ◽  
Teaching Hospital ◽  
Malignant Tumor ◽  
Histopathological Examination ◽  
Cross Sectional Study ◽  
Histopathological Diagnosis ◽  
Cross Sectional ◽  
Medical College ◽  
Histopathological Correlation

IntroductionClinical diagnosis of dermatological manifestation of neoplastic skin lesion can pose a diagnostic difficulty at times. Histopathological diagnosis is mandatory for accurate characterization of disease entity for proper and timely management of cases.ObjectiveThe aim of this study was to analyze malignant tumor of skin with respect to age, sex, clinical features and histopathological features and to evaluate the accuracy of clinical diagnosis with histopathological correlation.MethodologyThis is hospital based cross-sectional study conducted at Nepalgunj Medical College and Teaching Hospital, Kohalpur from February 2010 to January 2011. A total of 70 histopathological specimens of skin biopsies were studied and correlated with the clinical diagnosis. The data was entered into Microsoft  office excel and analyzed using statistical package for social sciences (SPSS 17.0).ResultsMalignant tumor of skin constituted 21.4% of total cases. In malignant tumor, most common sites were head and neck regions followed by lower limb with keratinocytic tumors being in the majority. Most of the specimens (65.7%) were obtained as excisional biopsies.  Seven cases diagnosed as benign lesions clinically, turned out to be malignant on histopathological examination. Out of 13 cases in which clinical diagnosis was of malignancy, only 8 turned out to be malignant, thus for malignant lesions, the clinical diagnosis had a sensitivity of 53.3%, specificity of 90.9% and a positive predictive value of 61.5%.ConclusionsSquamous cell carcinoma was the most common malignant tumor in this study and histopathological correlation significantly modifies the overall management in dermatological disorders where clinical diagnoses are equivocal.Birat Journal of Health SciencesVol.2/No.1/Issue 2/ Jan - April 2017, Page: 156-161

scholarly journals Clinicopathological correlation of uterine cervical lesions with focus on premalignant and malignant lesions

2019 ◽  
Vol 9 (2) ◽  
pp. 1560-1563
Author(s):  
Ramesh Makaju ◽  
Binod Dhakal ◽  
Rachana Dhakal
Keyword(s):  
Cell Carcinoma ◽  
Clinical Diagnosis ◽  
Clinical Examination ◽  
Pap Smear ◽  
Precancerous Lesions ◽  
Demographic Data ◽  
University Hospital ◽  
Histopathological Diagnosis ◽  
Cervical Lesions ◽  
Common Diagnosis

Background: Cervical cancer ranks as the most frequent cancer among women in Nepal and the first most frequent cancer among women between 15 and 44 years of age. The objectives of the study are to find the incidence of premalignant and malignant cervical conditions and to correlate histopathological diagnosis with that of clinical diagnosis. Materials and Methods: This was a retrospective study carried out at Kathmandu University Hospital. All cervical biopsy done from January 2009 to December 2018, were included in the study. A proforma was created in which relevant demographic data like age, sex along with clinical findings, gross and histopathological findings were collected. Results: Mean age of patients with cervical intraepithelial lesion- 1, 2 and 3 was 43.5 years, 48 years and 43.4 years respectively. The most common diagnosis was cervical polyp were (38.65%) followed by 52 cases (15.9%) of unhealthy cervix which bleeds easily on touch and 42 (12.8%) cases of inflammatory condition. Clinical diagnosis of carcinoma of cervix comprised of 42 cases (12.8%). On histopathology, 51(15.6%) cases had invasive carcinoma of which 48 (94.1%) were squamous cell carcinoma, two (3.92%) were adenocarcinoma, and one (1.9%) was of small cell carcinoma. In 33 cases (78.57%), clinical examination was correctly able to identify the invasive cancer. The sensitivity rate of diagnosing cancerous and precancerous lesions by clinical examination and cervical pap smear was 80.95 percent. Conclusions: Proper clinical history, examination, pap smearing and biopsy report helps through appropriate clinical intervention and prevents development of advanced stage of cervical carcinoma

Acute abdomen in pregnancy: a retrospective study of pregnant patients hospitalised for abdominal pain

2020 ◽  
Vol 99 (3) ◽  
pp. 131-135
Keyword(s):  
Abdominal Pain ◽  
Clinical Signs ◽  
University Hospital ◽  
Diagnostic Process ◽  
Abdominal Emergency ◽  
Lower Abdominal Quadrant ◽  
Abdominal Emergencies ◽  
The Right ◽  
Abdominal Quadrant ◽  
In Pregnancy

Introduction: Abdominal emergencies occur in pregnant women with the rate of 1:500−635 pregnancies. Such conditions usually develop from full health and worsen rapidly. Symptoms are often similar to those in physiological pregnancy (abdominal pain, vomiting, constipation). The diagnostic process is thus difficult and both the mother and her child are at risk. Our aim was to evaluate the frequency of abdominal emergencies in the Department of Surgery, University Hospital in Pilsen and to consider their impact on pregnancy and on the newborn. Methods: We acquired a set of patients by retrograde collection of data. We searched for pregnant patients suspected of developing an abdominal emergency admitted to the Department of Surgery, Faculty of Medicine, Pilsen between 2004 and 2015. We evaluated a number of clinical signs to statistically describe the set. Results: The set included 121 patients; 42 of the patients underwent a surgical procedure and 79 received conservative treatment. 38 patients underwent appendectomy; 6 appendixes were with no pathologies. McBurney’s incision was an approach of choice in most cases. The most frequent symptom was pain in the right lower abdominal quadrant. The foetus has been lost in none of the cases. Conclusion: Acute appendicitis was the most frequent abdominal emergency in our set and also the most frequent reason for surgical intervention. The most specific sign was pain in the right lower abdominal quadrant. No impact of appendicitis or appendectomy on the health of the newborn has been observed. Even though abdominal emergencies in pregnancy are relatively rare, the results of the department are very good.

STUDYING SOME CLINICAL AND PARACLINICAL CHARACTERISTICS OF POSMATURE BABIES CARED IN NICU AT HUE UNIVERSITY HOSPITAL

2012 ◽  
pp. 74-84
Author(s):  
Thi Kieu Nhi Nguyen
Keyword(s):  
Respiratory Rate ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
University Hospital ◽  
Maternal Characteristics ◽  
Exact Test ◽  
Menstrual Cycles ◽  
Term Newborns ◽  
Student’S T ◽  
The Individual

Objectives: 1. Estimating the ratios of clinical and paraclinical signs of post-term newborns hospitalized at Pediatric Department of Hue University Hospital. 2. Identifying the relation between clinical signs and paraclinical signs. Materials and Method: 72 post- term babies < 7 days of life hospitalized at NICU from 2010/5 to 2011/4. Classification of post - term newborn was based on WHO 2003: gestational age ≥ 42 weeks with clinical manifestations: desquamation on press with fingers or natural desquamation, withered or meconial umbilicus, meconial long finger nails (*) or geatational age still < 42 weeks with theses clinical manifestations (*). Data were recorded on a clinical record form. Per-protocol analysis of clinical outcomes was performed by using Medcalc 11.5 and Excell 2007. Analyses used the χ2 test or Fisher's exact test for categorical data; Student's t test was used for continuous data and the Mann-Whitney U test for nonparametric data. Data were presented as means or proportions with 95% CIs. Results: Clinical characteristics: Tachypnea and grasp were main reasons of hospitalisation (48.61%). Poor feeding, vomitting (16.67%). Asphyxia (8.34%). Jawndice (6.94%). Hypothermia < 36.50C (13.89%), fever (13.89%). Tachypnea (59.72%). Bradycardia (1.39%). Poor feeding (11.11%). Hypertonia (9.72%). Paraclinical characteristics: Erythrocytes < 4.5.1012/l (51.39%), Leucocytes 5 – 25.103/mm3 (81.94%), Thrombocytes 100- 400.103/mm3 (94.44%). Hemoglobinemia < 10mg/l (67.61%). Maternal characteristics: Menstrual cycles regular (75%). Primiparity (75%). Amniotic volume average (70.42%), little (29.58%). Aminiotic liquid clair (62.5%), aminiotic liquid yellow (4.17%), aminiotic meconial liquid (33.33%). Maternal manifestation of one of many risk factors consist of genital infection; urinary infection; fever before, during, after 3 days of birth; prolonged delivery; medical diseases influence the foetus (75%). The relation between clinical signs and paraclinical signs: There was significantly statistical difference: between gestationnal age based on obstetrical criteria and amniotic volume on ultrasound (p < 0.05); between birth weight and glucosemia p < 0.02). There was conversional correlation of average level between erythroctes number and respiratory rate (r = - 0.5158; p < 0,0001), concordance correlation of weak level betwwen leucocytes number and respiratory rate r = 0.3045; p = 0.0093). Conclusion: It should made diagnosis of postterm baby based on degree of desquamation. The mother who has menstrual cycles regular is still delivered of a postterm baby. A postterm baby has the individual clinical and paraclinical signs.

Isolated multidrug-resistant tubercular tenosynovitis of the flexor tendon of the little finger

2021 ◽  
Vol 14 (2) ◽  
pp. e238339
Author(s):  
Sunny Chaudhary ◽  
Subhajit Maji ◽  
Varun Garg ◽  
Vivek Singh
Keyword(s):  
Flexor Tendon ◽  
Extrapulmonary Tuberculosis ◽  
Functional Limitation ◽  
Clinical Signs ◽  
Multidrug Resistant ◽  
Interesting Case ◽  
Antitubercular Therapy ◽  
Histopathological Diagnosis ◽  
Rare Presentation ◽  
Little Finger

Isolated multidrug-resistant (MDR) tubercular tenosynovitis of the flexor tendons of finger without involvement of wrist is a rare presentation. Tenosynovitis of hand is an uncommon manifestation of extrapulmonary tuberculosis. Pyogenic flexor tenosynovitis of hand is frequently seen and is the closest differential. Non-specific clinical signs may lead to delay in diagnosis, which is often made after biopsy. Management includes surgical excision of necrotic tissue and infected synovium along with antitubercular therapy after histopathological diagnosis. MDR tuberculosis of hand is extremely rare and, to the best of our knowledge, has not been reported in the literature so far. We report an interesting case of MDR tubercular flexor tendon tenosynovitis of the little finger without any pulmonary involvement in an immunocompetent patient. The case was managed by complete synovectomy and second-line antitubercular therapy with complete resolution of disease and had no functional limitation.

scholarly journals Ophthalmic Histiocytic Lesions: A Baseline Demographic and Clinicopathological Study of 28 Cases From 2 Eye Centers

2021 ◽  
Author(s):  
Tariq A. Alzahem ◽  
Azza M.Y. Maktabi ◽  
HIND MANAA ALKATAN
Keyword(s):  
Relevant Literature ◽  
Age Groups ◽  
University Hospital ◽  
Future Research ◽  
Juvenile Xanthogranuloma ◽  
Published Data ◽  
Histopathological Diagnosis ◽  
Female Ratio ◽  
Rosai Dorfman Disease ◽  
Rare Group

Abstract Purpose: Ophthalmic histiocytic lesions comprise a heterogeneous rare group of disorders that are characterized by an abnormal proliferation of histiocytes and may affect all age groups of both genders. This rare group of diseases in the ophthalmic practice has not been previously studied in this area of the world and only individual cases reports were reported.Methods: This retrospective study has been approved on an expedited basis by the Human Ethics Committee/Institutional Review Board (HEC/IRB) at King Khaled Eye Specialist Hospital (KKESH) with a collaborative agreement between KKESH and King Abdulaziz University Hospital (KAUH) in Riyadh, Saudi Arabia aiming to collect all biopsied ocular and periocular histiocytic lesions from both centers from January 1993 to December 2018. The histopathological diagnosis was confirmed, and cases were re-classified by review of all histopathological slides. The corresponding demographic and clinical data were analyzed. Relevant literature review was also carried on for comparison of our collected analyzed data to published data and to draw our own conclusions.Results: A total of 34 ocular/periocular histiocytic lesions of 28 patients who were mostly Saudis (92.9%) were included. Male to female ratio was 4:3. The median age at presentation was 6.4 years (range: 2.8-35). Twenty-two patients had unilateral involvement and 6 patients had bilateral lesions. In Langerhans cell histiocytosis (LCH)=L group, the most common presenting findings were eyelid swelling (75%), periocular tenderness (37.5%), proptosis/globe displacement (37.5%) eyelid erythema (25%), and orbital pain (12.5%). In Rosai Dorfman disease (RDD)=C group, proptosis/globe displacement occurred in all patients, followed by decreased vision (80%). Patients with C group diseases had variable clinical features owing to the different locations of the histiocytic lesions with the majority involving the eyelids (66.7%). Diagnosis was accurately reached clinically in 38.8%, 33.7%, and 46.7% among patients in the L group, C group, and R group respectively. Overall, the clinical diagnosis was in concordance with the histopathologic diagnosis in 14 only out of 34 lesions (41.2%). Conclusions: We concluded that C group was the commonest histiocytic lesion encountered in about two-thirds of the lesions with particular prevalence of Juvenile xanthogranuloma (JXG). The histiocytic disease is more likely to be overlooked clinically especially in this group owing to its rarity and is diagnosed mainly with the help of histopathological and immunohistochemical studies. The median age of presentation was higher for R group patients, while there was tendency for JXG to present at a later age compared to the published reports. Intraocular involvement was extremely rare. All L group cases were strictly unilateral disease, while RDD (C group) was most commonly bilateral. Future research on the genetic aspects, management, and prognosis are necessary.

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