The Accuracy of Histopathological and Cytopathological Techniques in the Identification of the Mycetoma Causative Agents

Mycetoma is a devastating neglected tropical disease, caused by various fungal and bacterial pathogens. Correct diagnosis to the species level is mandatory for proper treatment. In endemic areas, various diagnostic tests and techniques are in use to achieve that, and that includes grain culture, surgical biopsy histopathological examination, fine needle aspiration cytological (FNAC) examination and in certain centres molecular diagnosis such as PCR. In this retrospective study, the sensitivity, specificity and diagnostic accuracy of grain culture, surgical biopsy histopathological examination and FNAC to identify the mycetoma causative organisms were determined. The histopathological examination appeared to have better sensitivity and specificity. The histological examination results were correct in 714 (97.5%) out of 750 patients infected with Madurella mycetomatis, in 133 (93.6%) out of 142 patients infected with Streptomyces somaliensis, in 53 (74.6%) out of 71 patients infected with Actinomadura madurae and in 12 (75%) out of 16 patients infected with Actinomadura pelletierii. FNAC results were correct in 604 (80.5%) out of 750 patients with Madurella mycetomatis eumycetoma, in 50 (37.5%) out of 133 Streptomyces somaliensis patients, 43 (60.5%) out of 71 Actinomadura madurae patients and 11 (68.7%) out of 16 Actinomadura pelletierii. The mean time required to obtain the FNAC result was one day, and for the histopathological examinations results it was 3.5 days, and for grain it was a mean of 16 days. In conclusion, histopathological examination and FNAC are more practical techniques for rapid species identification than grain culture in many endemic regions.

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Cytohistological Concordance of Papillary Carcinoma of Thyroid and Its Variants

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/41 ◽

2021 ◽

Vol 8 (04) ◽

pp. 213-218

Author(s):

Nameera Saleem ◽

Naval Kishore Bajaj ◽

Ezhil Arasi Nagamuthu

Keyword(s):

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Papillary Carcinoma ◽

Fine Needle Aspiration ◽

Histopathological Examination ◽

Correct Diagnosis ◽

Needle Aspiration ◽

Papillary Thyroid ◽

Fine Needle ◽

Nuclear Features

BACKGROUND Papillary thyroid carcinoma is the most common malignancy of the thyroid gland. Fine Needle Aspiration Cytology (FNAC) is a rapid, safe and economic procedure, and has a sensitivity approaching of 93.5 % and specificity close to 90 % for diagnosing papillary thyroid carcinomas. This study aims at correlating the cytological and histological diagnosis to arrive at the rate of concordance and discordance, identify variants of papillary thyroid carcinoma (PTC) on cytology and discuss the cytological mimics of PTC. METHODS Data from cases was collected over a period of three years (2015 - 2018). A descriptive study was done. Cases from Osmania General Hospital representing histologically proven cases of papillary carcinoma thyroid along with their corresponding cytological findings were analysed. Cytosmears were obtained from fine needle aspiration of thyroid lesions using a 26-gauge needle, stained with haematoxylin and eosin (H&E). Thyroidectomy specimens were fixed in 10 % buffered formalin, grossed and paraffin embedded. After processing, sections obtained by microtomy were stained with H & E for histopathologic evaluation. RESULTS The institute received a total of 258 thyroid specimens for histopathology and 686 cases for thyroid FNAC over a period of three years. This study includes 70 cases which had both cytology and histopathology correlation at our institution. 65 cases were diagnosed as PTC on histopathology and correct diagnosis was made on cytology with 73.8 % concordance (48 / 65 cases) and discordance was seen in 26.1 % (17 / 65 cases). 5 cases were misdiagnosed on cytology as PTC, and on histopathological examination were diagnosed as non-PTC. CONCLUSIONS Fine needle aspiration shows variable accuracy for PTC, ranging from 65 % to 90 %. The architectural arrangement of cells in papillary fragments and presence of nuclear features in majority of cells is diagnostic of the conventional variant of PTC. The other variants however, pose a diagnostic dilemma on account of their architectural variation, altered cytomorphology and the scant presence of nuclear features. An increase in the awareness of cytomorphology of variants and also of the mimics of PTC helps improve the diagnostic accuracy on FNAC. KEYWORDS Papillary Thyroid Carcinoma, Variants of PTC, Cytohistopathological Correlation

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The diagnostic value of ultrasonography in detection of different types of thyroid nodules

The Egyptian Journal of Otolaryngology ◽

10.1186/s43163-020-00025-1 ◽

2020 ◽

Vol 36 (1) ◽

Author(s):

Ahmed Youssef ◽

Mohamed Hesham Abd-Elmonem ◽

Rania Ahmed Mohamed Ghazy ◽

Mohamed Mahmoud El Shafei ◽

Mohamed Zahran

Keyword(s):

Thyroid Nodule ◽

High Frequency ◽

Thyroid Nodules ◽

Histopathological Examination ◽

Final Diagnosis ◽

Diagnostic Value ◽

Needle Aspiration ◽

High Frequency Ultrasound ◽

Different Types ◽

Sensitivity Specificity

Abstract Background This article discusses the importance of high frequency ultrasonography in detection of different types of thyroid nodules considering only the histopathological examination of the surgical specimens as the final diagnosis. We studied 50 patients referred to ENT clinic with a thyroid nodule. Ultrasonography and ultrasound-guided fine-needle aspiration biopsy were done to all the patients. Thyroid surgery was done according to FNAB results. Result From 50 thyroid specimens, the US could predict the malignancy in 18 specimens. By histopathology, only 16 specimens were malignant, and 34 were benign thyroid disease. The sensitivity, specificity, and accuracy of US were 100%, 94.12%, and 96% respectively. The most suspicious ultrasongraphic feature was microcalcification followed by taller than wider (T ˃ W). Conclusion High frequency ultrasound is a very important tool to predict the malignant possibility during thyroid nodule evaluation.

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Giant gastric carcinosarcoma infiltrating the left hepatic lobe: a case report

International Journal of Case Reports ◽

10.28933/ijcr-2021-03-2606 ◽

2021 ◽

pp. 214

Author(s):

◽

Keyword(s):

Gastric Resection ◽

Histopathological Examination ◽

Correct Diagnosis ◽

Immunohistochemical Analysis ◽

Needle Aspiration ◽

Left Hepatic Lobe ◽

En Bloc ◽

Hepatic Lobe ◽

Biopsy Specimens ◽

Resected Tissue

Gastric carcinosarcoma is a rare biphasic tumor that consists of both carcinomatous and sarcomatous components. Clinical presentation and neoplastic markers are not specific for the disease. Moreover, CT scan cannot distinguish among gastric carcinoma, sarcoma or carcinosarcoma, so it is essential to perform histopathological and immunohistochemical analysis on biopsy specimens or resected tissue to ensure a correct diagnosis. A 72-year-old woman was transferred to our Department from another hospital with a diagnosis of a bleeding tumor localized on the lesser gastric curve, infiltrating the left hepatic lobe. The mass was treated as a gastric malignant mesenchymal neoplasia (gastro-intestinal stromal tumor versus sarcoma) infiltrating the liver. Owing to the bleeding, no further invasive examinations, such as fine needle aspiration biopsy, were planned. Furthermore, no neoadjuvant chemotherapy could be administered before surgery due to persistent anaemia. The scheduled surgical procedure was an atypical gastric resection with “en bloc” hepatic resection. This operation included upper polar and lesser curve resection, with tubulization of the stomach along the greater curve, as well as left lateral hepatic sectionectomy. Histopathological examination and immunohistochemical staining confirmed the diagnosis of gastric carcinosarcoma. This is first report of gastric carcinosarcoma with local liver infiltration, treated with surgical resection.

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Clinicopathological and Radiological Profile of Multinodular Goitre – A Prospective Study

Bengal Journal of Otolaryngology and Head Neck Surgery ◽

10.47210/bjohns.2021.v29i2.479 ◽

2021 ◽

Vol 29 (2) ◽

pp. 164-168

Author(s):

Koustav Mondal ◽

Chiranjib Das

Keyword(s):

Diagnostic Accuracy ◽

Predictive Value ◽

Histopathological Examination ◽

Tertiary Care ◽

Final Diagnosis ◽

Needle Aspiration ◽

Histopathological Diagnosis ◽

Care Hospital ◽

Multinodular Goitre ◽

Sensitivity Specificity

Introduction Multinodular goitre (MNG) is defined as multiple palpable distinct nodules in the enlarged thyroid gland. MNG can harbour malignancy in 1-10% cases. We undertook the present study to correlate the clinical, radiological and cytological features of MNG with that of final histopathological diagnosis. Materials and Methods A prospective cohort study was done in a tertiary care hospital in northern part of West Bengal from January 2018 to December 2019. Patients aged between 12 years and 75 years, presenting with MNG on clinical examination, were included in the study. We compared the pre-operative ultrasonography (USG) of neck and fine needle aspiration cytology (FNAC) reports with post-operative histopathological examination (HPE) report. Results Among 100 patients 80 were female and 20 were male. Most patients were in 41-50 years age group. For detection of malignancy in MNG, USG had 40% sensitivity, 97.78% specificity, 66.67% positive predictive value (PPV), 93.62% negative predictive value (NPV), and 92% diagnostic accuracy. Sensitivity, specificity, PPV, NPV and diagnostic accuracy of FNAC for detection of malignancy in MNG were 20%, 93.33%, 25%, 91.3% and 86% respectively. When USG features were combined with FNAC features non-diagnostic result decreased from 6% to 2% and diagnostic accuracy for detecting malignancy in MNG increased from 86% to 90%. Conclusion USG and FNAC are complementary to each other in the diagnostic workup of MNG. USG guided FNAC is still better for reaching final diagnosis and exclusion of malignancy.

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Evaluation of efficacy of Ultrasound in diagnosis of Neck Swellings

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20175620 ◽

2017 ◽

Vol 4 (1) ◽

pp. 169 ◽

Cited By ~ 1

Author(s):

Akriti Rastogi ◽

Karan Sharma ◽

Neelam Gauba

Keyword(s):

Histopathological Examination ◽

Final Diagnosis ◽

Needle Aspiration ◽

Incision And Drainage ◽

Ultrasound Findings ◽

Malignant Lesions ◽

Needle Aspiration Cytology ◽

Initial Imaging ◽

Sensitivity Specificity ◽

Malignant Lymph Nodes

Background: Neck swellings are a common cause of dilemma to clinicians. Accurate diagnosis of neck swellings is of paramount importance. This study evaluated patients with neck swellings to study their ultrasonographic features and correlated the ultrasound findings with the final diagnosis.Methods: 100 patients with neck swellings were evaluated clinically and divided into four groups– congenital, inflammatory, benign and malignant. Thereafter, they underwent high-resolution Ultrasound (US) and the ultrasonographic features of each type of swelling were studied. A final diagnosis was established after further evaluation using FNAC, further imaging, surgical intervention in the form of incision and drainage or excision/incisional biopsy with histopathological examination or successful non-surgical treatment. Ultrasound findings were compared with final diagnosis. Results: For swellings of inflammatory nature, this study showed the sensitivity, specificity, PPV and NPV of US to be 87.2%, 96.6%, 94.4%, 91.9% respectively. For benign swellings, sensitivity, specificity, PPV and NPV was 97.5%, 91.3%, 88.6% and 98.1% respectively. Sensitivity of US in diagnosing malignant lesions of the neck was 87.5% with a specificity of 98.7%, PPV 93.3% and NPV 97.5%. Sensitivity of US in detecting thyroid malignancy in the present study was 83.3% and in diagnosing malignant lymph nodes was 87.5%.Conclusions: Ultrasound is the ideal modality for initial imaging for neck swellings. Later on, as per the need and Ultrasound findings, one can go in for further haematological investigations, Fine Needle Aspiration Cytology and Radiological investigations.

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F.N.A.C. AS DIAGNOSTIC TOOL OF PAROTID TUMORS AND ASSOCIATED PITFALLS IN CORRELATION WITH HISTOPATHOLOGY

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i1.1153 ◽

2020 ◽

Vol 4 (1) ◽

Author(s):

Bhawana Pant ◽

Sanjay Gaur ◽

Prabhat Pant

Keyword(s):

Preoperative Diagnosis ◽

Histopathological Examination ◽

Clinical Information ◽

Final Diagnosis ◽

Needle Aspiration ◽

Histopathological Diagnosis ◽

Cytological Diagnosis ◽

Tertiary Referral Centre ◽

Clear Cut ◽

Parotid Tumors

F.NA.C has been used for ages as a safe and economical tool for fast preoperative diagnosis of parotid tumors. It has certain pitfall which sometimes leads to misdiagnosis and consequently it may have affect on treatment of the tumors. Keeping in view of the diverse classification of parotid tumors’ information from cytology should be combined with radiology as well as clinical diagnosis. Aim: To discuss some cases where there was discrepancy between cytological diagnosis and histopathological result and also suggest measures to improve the efficacy of F.N.A.C. Material and methods: The study includes 50 cases of parotid tumours who presented to the department of ENT at Government medical college Haldwani which is a tertiary referral centre during 2009 to 2016. Only adult patients were included and inflammatory swelling were excluded from the study. All patients evaluated Contrast enhanced computerized tomography(CECT) and Magnetic resonance imaging (MRI) followed by Fine needle aspiration cytology .Preoperative diagnosis was made upon the findings of the above investigations and different types of parotid surgeries were done. . Final diagnosis was made on histopathological examination. Result :The most common tumour came out to be pleomorphic adenoma (23 cases-46%) followed by mucoepidermoid carcinoma(12cases-24%). In ten cases there was no clear cut association between cytological diagnosis and final histopathological diagnosis. Conclusion: FNAC is highly sensitive and specific technique for diagnosis of many salivary gland swellings. FNAC can be used preoperatively to avoid unnecessary surgery and biopsy. Details of clinical information and radiologic features may help the pathologist to arrive at the appropriate diagnosis and reduce false interpretation. Pitfalls may also occur with improper technique of FNAC which can be overcome by proper caution.

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The “gray zone” in fine-needle aspiration cytology of the organized mammography screening. Cytohistological correlation

Orvosi Hetilap ◽

10.1556/oh.2011.29023 ◽

2011 ◽

Vol 152 (8) ◽

pp. 292-295

Author(s):

Mihály Bak ◽

Éva Konyár ◽

Ferenc Schneider ◽

Mária Bidlek ◽

Éva Szabó ◽

...

Keyword(s):

Fine Needle Aspiration ◽

Mammography Screening ◽

Fine Needle Aspiration Cytology ◽

Benign Lesion ◽

Needle Aspiration ◽

Gray Zone ◽

Aspiration Cytology ◽

Surgical Biopsy ◽

Fine Needle ◽

Needle Aspiration Cytology

The National Public Health Program has established the organized mammography screening in Hungary. The aim of this study was to conduct an audit of “gray zone” smears of the organized mammography screening in comparison with histopathological diagnoses. Methods: Cytology results were rated to C3 atypia probably benign and C4 suspicious of malignancy. Results: 1361 women had aspiration cytology performed from a total of 47,718 mammography non-negative lesions. 105 (7.8%) were diagnosed as C3, whereas 78 (5.7) as C4. Of the 105 patients with C3 diagnosis 61 (58%) patients underwent surgical biopsy. Histology proved malignancy in 20 (32.8%) cases, and benign lesion in 41 (67.2%) cases. All (100%) of the 78 patients with C4 diagnosis had open biopsies; 69 (88.4%) cases were histologically malignant and 9 (11.6%) cases were benign lesions. Conclusion: The auditing results of fine needle aspiration cytology of “gray zone” in organized mammography screening meet the proposed threshold values. Authors conclude that the “gray zone” category in breast cytology is useful and of value if used judiciously. Orv. Hetil., 2011, 152, 292–295.

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Correlation of FNAC and histopathology in diagnosis of salivary gland lesions

Journal of Pathology of Nepal ◽

10.3126/jpn.v4i8.11593 ◽

2014 ◽

Vol 4 (8) ◽

pp. 654-657 ◽

Cited By ~ 2

Author(s):

S Koirala ◽

G Sayami ◽

AD Pant

Keyword(s):

Salivary Gland ◽

Preoperative Diagnosis ◽

Needle Aspiration ◽

University Teaching ◽

Malignant Neoplasms ◽

Histopathological Diagnosis ◽

Institute Of Medicine ◽

Needle Aspiration Cytology ◽

Sensitivity Specificity ◽

Diagnostic Pitfalls

Background: Value of fine needle aspiration cytology in preoperative diagnosis of salivary gland lumps has been established in various studies. This study aims to calculate sensitivity, specificity accuracy of FNAC, correlate FNAC findings with histopathology and find out reasons for common diagnostic pitfalls in FNAC.Materials and methods: This study was performed in 67 patients that presented with salivary gland lumps at Department of pathology, Tribhuvan University Teaching Hospital, Institute of medicine, Kathmandu, Nepal from January 2009 to June 2010. FNAC was performed and was correlated with histopathological diagnosis to judge the sensitivity, specificity and accuracy of FNAC.Results: Out of 36 cases there was cyto-histological correlation in 28 cases. Pleomorphic adenoma was the most frequent lesion in this study. Parotid gland was the most common site affected by salivary gland lesions. The sensitivity, specificity and accuracy for non-neoplastic lesions was 100%, 89.28%, 91.67%, for benign neoplasms was 100%, 86.95%, 91.67% and for malignant neoplasms was 57.14%, 100%, 83.33% respectively.Conclusion: FNAC is a useful tool in preoperative diagnosis of salivary gland lesions and can be crucial for the management of the patient. Aspiration and reporting of salivary gland lesions demands a competent pathologist who considers all the possible diagnostic pitfalls in mind.DOI: http://dx.doi.org/10.3126/jpn.v4i8.11593 Journal of Pathology of Nepal; Vol.4,No. 8 (2014) 654-657

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Pleomorphic Adenoma of the Submandibular Gland in a 10-Year-Old Child: A Case Report

Ear Nose & Throat Journal ◽

10.1177/01455613211022113 ◽

2021 ◽

pp. 014556132110221

Author(s):

Bouatay Rachida ◽

Ons Kharrat ◽

Wiem Boughzala ◽

Seifeddine Ben Hammouda ◽

Nouha Ben Abdeljelil ◽

...

Keyword(s):

Submandibular Gland ◽

Pleomorphic Adenoma ◽

Fine Needle Aspiration ◽

Histopathological Examination ◽

Preoperative Evaluation ◽

Needle Aspiration ◽

Magnetic Resonance Images ◽

Fine Needle ◽

Sebaceous Cyst ◽

Growing Mass

We report the case of a 10-year-old girl with a painless slowly growing mass that had developed over the course of 2 years in the left submandibular area. Physical examination revealed a firm painless submandibular mass with no other associated signs. Ultrasound graphics were in favor of a sebaceous cyst. Fine-needle aspiration and magnetic resonance images (MRI) concluded to a pleomorphic adenoma of the submandibular gland. The patient underwent left submandibulectomy. Histopathological examination confirmed the diagnosis of pleomorphic adenoma arising from the submandibular gland. The postoperative course was uneventful. Pleomorphic adenoma of the submandibular gland represents a diagnostic and therapeutic dilemma in children. Preoperative evaluation, including MRI and fine-needle aspiration, is recommended. Total submandibulectomy is also recommended to minimize recurrences and to avoid malignant transformation.

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Different characteristics of infants diagnosed with congenital choledochal malformation prenatally or postnatally

Scientific Reports ◽

10.1038/s41598-020-79569-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Wei Chen ◽

Jia Geng ◽

Ya-lan Tan ◽

Lian Zhao ◽

Hui-hui Jia ◽

...

Keyword(s):

Histopathological Examination ◽

Fibrous Tissue ◽

Operation Time ◽

Normal Diet ◽

Treatment Regimens ◽

Total Length ◽

Time Required ◽

Different Characteristics ◽

Length Of Hospitalization ◽

Choledochal Malformation

AbstractThe general condition, clinical and pathological characteristics, and treatment regimens of patients prenatally and postnatally diagnosed with congenital choledochal malformation (CM) were analyzed in order to investigate the clinical significance of early diagnosis, treatment, and intervention in CM. We retrospectively analyzed 33 children who were admitted to the Children’s Hospital of Soochow University between 1 March 2010 and 31 May 2019, and their diagnosis of CM was confirmed by radiological, surgical and pathological findings. All the patients were under 36 months of age. The patients were divided into prenatally diagnosed and postnatally diagnosed groups. There were 16 and 17 CM patients in the prenatally and postnatally diagnosed groups, respectively, with a preponderance of females in both groups. Compared with the prenatally diagnosed group, the postnatally diagnosed group had a higher incidence of abdominal pain and vomiting (p < 0.05) and higher AST, GGT, and TB levels (p < 0.05). Although postoperative histopathological examination showed inflammation in both groups, congestion in the cyst walls and fibrous tissue hyperplasia were more significant in the postnatally diagnosed group (p < 0.05). In addition, operation time, length of time required to resume a normal diet after surgery, and total length of hospitalization differed between the 2 groups (p < 0.05), with the prenatally diagnosed group having a relatively longer operation time and taking longer to resume a normal diet after surgery. However, the total length of hospitalization in the prenatally diagnosed group was shorter than that in the postnatally diagnosed group. Compared with prenatally diagnosed CM patients, more symptoms, greater severity of symptoms, and more time to recovery after surgery were observed in postnatally diagnosed CM patients.

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