MOC31 Immunostaining in the Diagnosis of Metastatic Adenocarcinoma in Serous Fluid: Special Emphasis on Atypical Cytological Cases

2021 ◽  
pp. 1-8
Author(s):  
Saumya Sahu ◽  
Shelly Sharma ◽  
Parikshaa Gupta ◽  
Pranab Dey
Keyword(s):  
Sensitivity And Specificity ◽  
Serous Effusion ◽  
Metastatic Adenocarcinoma ◽  
Diagnostic Dilemma ◽  
Diagnostic Role ◽  
Atypical Cells ◽  
Cytological Features ◽  
Effusion Fluid

<b><i>Background:</i></b> The diagnosis of atypical cases in the effusion cytology sample often poses a challenge to the cytologists. <b><i>Aims and Objectives:</i></b> We evaluated the diagnostic role of MOC31 in the metastatic adenocarcinoma in effusion fluid. <b><i>Materials and Methods:</i></b> The cytological examination and MOC31 immunostaining in the cell block sections were carried out in 64 cases of serous effusion. A total of 23 cases showed atypical cytology, out of which suspicious for malignancy (SFM) and atypia of undetermined significance (AUS) were 19 and 4 cases, respectively. In these cases, we also performed calretinin immunostaining. The cytological features, results of MOC31 immunostaining, and follow-up data were correlated to find out the sensitivity and specificity of MOC31 immunostaining in the diagnosis of metastatic adenocarcinoma. <b><i>Result:</i></b> The sensitivity and specificity of MOC31 were 100%. MOC31 detected all the cases of metastatic adenocarcinoma. MOC31 showed strong positivity in 19 cases of SFM. All these cases had a malignant outcome in histopathology or follow-up data. In AUS cases, MOC31 immunostaining was negative with a benign outcome. In all the atypical but malignant cases calretinin stain showed diffuse cytoplasmic and nuclear positivity. In contrast, MOC31 showed strong membranous positivity and occasionally cytoplasmic positivity. <b><i>Conclusion:</i></b> MOC31 is an excellent marker of metastatic adenocarcinoma in the serous effusion. The membranous positivity of MOC31 and negative calretinin immuno­staining are helpful in atypical cytological cases to avoid the diagnostic dilemma. The MOC31 positivity is significantly useful in discrete atypical cells which are more challenging to recognize.

scholarly journals 332 The diagnostic role of shunt series radiographs (SSR) in children presenting to the children’s emergency department (CED) with suspected ventriculoperitoneal (VP) shunt failure

2020 ◽  
Vol 37 (12) ◽  
pp. 852.3-853
Author(s):  
Angharad Griffiths ◽  
Ikechukwu Okafor ◽  
Thomas Beattie
Keyword(s):  
Clinical Outcome ◽  
Sensitivity And Specificity ◽  
Clinical Information ◽  
Flow Diagram ◽  
List Type ◽  
Shunt Failure ◽  
Vp Shunt ◽  
Wide Range ◽  
Diagnostic Role

Aims/Objectives/BackgroundVP shunts are used to drain CSF from the cranial vault because of a wide range of pathologies and, like any piece of hardware, can fail. Traditionally investigations include SSR and CT. This project examines the role of SSR in evaluating children with suspected VP shunt failure.Primary outcome: Sensitivity and specificity of SSR in children presenting to the CED with concern for shunt failure.Methods/DesignConducted in a single centre, tertiary CED of the national Irish Neurosurgical(NS) referral centre (ED attendance:>50,000 patients/year). 100 sequential SSR requested by the CED were reviewed. Clinical information was extracted from electronic requests. Shunt failure was defined by the need for NS intervention(Revision).Abstract 332 Figure 1Abstract 332 Figure 2Results/ConclusionsSensitivity and specificity is presented in figure 1 (two by two table).100 radiographs performed in 84 children.22% shunts revised (see flow diagram).7 SSR’s were abnormal.85% (n=6) shunts revised. [5 following abnormal CT].Of the normal SSR’s; 16 had abnormal CT and revised.85/100 received CT.64 of 85 CT’s (75%) were normal.□6 of the 64 had focal shunt concern.SSR’s shouldn’t be used in isolation. NPV&PPV, Sensitivity&Specificity is low.SSR’s are beneficial where there’s concern over focal shunt problems (injury/pain/swelling) or following abnormal CT.VP shunt failure is not well investigated with SSR alone.SSR’s could be omitted where there is no focal shunt concern/after normal CT (without impacting clinical outcome) reducing radiation exposure and reduce impact on CED’s.59 SSR’s could have been avoided without adverse clinical outcome.

scholarly journals Sarcoidosis vs. Colon Cancer Metastasis: Diagnostic Dilemma and the Role of PET Scan in Monitoring Disease Activity

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Raai Mahmood ◽  
Kadhim Al Banaa ◽  
Israa Ibrahim ◽  
Ahmed Hashim ◽  
Luis Torregrosa
Keyword(s):  
Colon Cancer ◽  
Disease Activity ◽  
Cancer Metastasis ◽  
Pet Scan ◽  
Inflammatory Disorder ◽  
Diagnostic Dilemma ◽  
Diagnosis Of Cancer ◽  
Noncaseating Granulomas

Sarcoidosis is a systemic inflammatory disorder characterized by “noncaseating granulomas.” It primarily affects the lungs, but multiple other organs can be involved. Sarcoidosis has been increasingly reported in association with cancer. It can precede, follow or occur at the same time as the diagnosis of cancer. We report a case of sarcoidosis that was diagnosed concomitantly with colon cancer, highlighting the diagnostic dilemma of sarcoidosis vs. cancer metastasis, the relationship between the two, and the value of PET scan in follow-up and monitoring of disease activity.

scholarly journals Cleveland Clinic Socre – What is the Role of a Novel Prognostic Treadmil Score to Diagnose Coronary Artery Disease?

2019 ◽  
Vol 14 (2) ◽  
pp. 62-66
Author(s):  
Md Mashiul Alam ◽  
Md Mukhlesur Rahman ◽  
Tanjima Parvin ◽  
Khurshed Ahmed ◽  
SM Mustafa Zaman ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Sensitivity And Specificity ◽  
Cleveland Clinic ◽  
Test Accuracy ◽  
Male And Female ◽  
St Segment ◽  
Diagnostic Role ◽  
Artery Disease

Background: Ischemic heart disease is increasing all over the world even in the developing countries like Bangladesh. The incidence rate of coronary artery disease is escalating very rapidly among both male and female population in our country. Though exercise treadmill test (ETT) is a well accepted non-invasive investigation to diagnose Coronary Artery Disease (CAD), it has a high false positive and false negative result if ST segment response alone is calculated for interpretation of the test. Accuracy of different treadmill scores in our population is largely unknown. Clevelan Clinic Score is a prognostic ETT score which is validated for prognostic indication but may have some diagnostic value as well. Objective: To know the diagnostic role of Cleveland Clinic Score, currently which has only prognostic implication. Method: A Cross-Sectional study was carried out on patients attending University Cardiac Center in Bangabandhu Sheikh Mujib Medical University (BSMMU) for stable chest pain to find out the accuracy of Cleveland Clinic Scores (CCS) in comparison to other diagnostic treadmill scores namely Duke Treadmill Score (DTS) and Simple Treadmill Score (STS).Total 130 persons including male and female who have undergone ETT were included according to inclusion and exclusion criteria. Coronary angiogram reports were collected after the procedure was performed as per clinical practice. The accuracy of ST segment response & different treadmill scores were calculated and compared with each other. Result: ETT scores had better sensitivity and specificity than ST segment response which was affected by workup bias more. CCS, DTS and STS have 83.3% & 60.9%; 71.4% & 71.7%; 64.3% & 78.3% sensitivity & specificity, respectively. Receiver Operator Characteristics (ROC) curve analysis showed all of the three scores have similar area under curve (AUC) that means they have similar accuracy to diagnose CAD. But they have different sensitivity and specificity for different cut off value. Overall analysis showed accuracy of STS (83.9%) is comparable to that of DTS (83.3%), CCS (77%) . Conclusion: Among the three treadmill scores Cleveland Clinic Score has comparable predictive accuracy when compared with DTS, STS. Though a prognostic ETT score, CCS may have diagnostic role which need to be validated further. University Heart Journal Vol. 14, No. 2, Jul 2018; 62-66

scholarly journals Lethal Midline Granuloma in a 15-Year-Old Girl: A Diagnostic Dilemma

2018 ◽  
Vol 33 (2) ◽  
pp. 37-40
Author(s):  
Ian Christian A. Gonzales
Keyword(s):  
Nk Cell ◽  
Cell Lymphoma ◽  
Diagnostic Dilemma ◽  
Lethal Midline Granuloma ◽  
Multiple Biopsies ◽  
Atypical Cells ◽  
High Index Of Suspicion ◽  
Lost To Follow Up ◽  
Midline Granuloma

Objective: To report a case of lethal midline granuloma and discuss the diagnostic and treatment dilemma, and management. Methods             Design:           Case Report             Setting:           Tertiary Government Hospital             Patient:           One Results: A 15-year-old girl under treatment for pulmonary tuberculosis presented to the Emergency Room for epistaxis and a nasopalatine lesion. She was managed as a case of nasopalatine osteomyelitis for one month and discharged on antibiotics. She returned due to bleeding after being lost to follow up for 3 more months. Hemostasis, debridement and biopsy yielded atypical cells, possibly lymphoma. Immunohistochemistry confirmed the diagnosis of NK-cell lymphoma. Unfortunately, she expired prior to initiation of chemotherapy. Conclusion: Clinicians must have a high index of suspicion for lethal midline granuloma in chronic, non-healing midline lesions. Multiple biopsies confirm the diagnosis, and earlier initiation of treatment may improve prognosis.   Keywords: Granuloma, lethal midline; Lymphoma, extranodal NK-T-cell

scholarly journals Diagnostic role of colour Doppler US at 1-year follow-up after orthotopic liver transplantation

2010 ◽  
Vol 115 (8) ◽  
pp. 1304-1313 ◽  
Author(s):  
C. Gazzera ◽  
G. Isolato ◽  
S. Stola ◽  
F. Avogliero ◽  
A. Ricchiuti ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Orthotopic Liver Transplantation ◽  
Colour Doppler ◽  
Doppler Us ◽  
Diagnostic Role

scholarly journals Predicting Outcome in Comatose Patients: The Role of EEG Reactivity to Quantifiable Electrical Stimuli

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Gang Liu ◽  
Yingying Su ◽  
Yifei Liu ◽  
Mengdi Jiang ◽  
Yan Zhang ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Inclusion Criteria ◽  
Group 6 ◽  
Stroke Group ◽  
Predicting Outcome ◽  
Poor Outcomes ◽  
Electrical Stimuli

Objective. To test the value of quantifiable electrical stimuli as a reliable method to assess electroencephalogram reactivity (EEG-R) for the early prognostication of outcome in comatose patients.Methods. EEG was recorded in consecutive adults in coma after cardiopulmonary resuscitation (CPR) or stroke. EEG-R to standard electrical stimuli was tested. Each patient received a 3-month follow-up by the Glasgow-Pittsburgh cerebral performance categories (CPC) or modified Rankin scale (mRS) score.Results. Twenty-two patients met the inclusion criteria. In the CPR group, 6 of 7 patients with EEG-R had good outcomes (positive predictive value (PPV), 85.7%) and 4 of 5 patients without EEG-R had poor outcomes (negative predictive value (NPV), 80%). The sensitivity and specificity were 85.7% and 80%, respectively. In the stroke group, 6 of 7 patients with EEG-R had good outcomes (PPV, 85.7%); all of the 3 patients without EEG-R had poor outcomes (NPV, 100%). The sensitivity and specificity were 100% and 75%, respectively. Of all patients, the presence of EEG-R showed 92.3% sensitivity, 77.7% specificity, 85.7% PPV, and 87.5% NPV.Conclusion. EEG-R to quantifiable electrical stimuli might be a good positive predictive factor for the prognosis of outcome in comatose patients after CPR or stroke.

scholarly journals Diagnostic role of rapid urinary trypsinogen-2 strip test in acute pancreatitis

2021 ◽  
Vol 8 (5) ◽  
pp. 1674
Author(s):  
Meenal Jain ◽  
Vinoth Sundaresan ◽  
Siddhartha Gowthaman ◽  
Ramanathan Manickam
Keyword(s):  
Acute Pancreatitis ◽  
Acute Abdomen ◽  
Sensitivity And Specificity ◽  
Serum Amylase ◽  
Laboratory Methods ◽  
Pubmed Central ◽  
Diagnostic Role ◽  
Surgical Conditions ◽  
Strip Test

Acute pancreatitis is one of the most common surgical conditions that present with acute abdomen. Serum amylase and lipase are one of the most important and widely used laboratory methods to diagnosis acute pancreatitis. However, these tests have had unsatisfactory results in terms of their sensitivity and specificity. Urinary trypsinogen-2 strip test has been developed for the detection of increased levels of trypsinogen-2 in urine and has been suggested to play an important role in the screening of aucte pancreatitis on the basis of its rapid results. In this review, we aimed to assess the diagnostic role of the same existing articles using databases like pubmed, google scholar, medline, pubmed central. We analysed about 50 articles all of which were in English and 15 were excluded on the basis of our subject criteria. 

scholarly journals Isolated Fracture of the Corpus Spongiosum- A Rare Case with Atypical Presentation and Diagnostic Role of MRI

2021 ◽  
Author(s):  
Selvin Theodore Jayanth ◽  
Vivek Venkatramani ◽  
Rajiv Paul Mukha
Keyword(s):  
Tunica Albuginea ◽  
Corpus Spongiosum ◽  
Rare Form ◽  
Urethral Strictures ◽  
Diagnostic Role ◽  
Early Exploration ◽  
One Year ◽  
Erect Penis

Penile fractures occur due to rupture of the corpora cavernosum or tunica albuginea secondary to blunt or sexual trauma to the erect penis. They typically present with rapid detumescence of the penis, with pain, swelling and ecchymosis. Approximately 10-20% of penile fractures involve the urethra. The report presents a 28-years-old male patient that complained of per-urethral bleeding, following an injury to an erect penis. With the help of MRI and intra-operative cystoscopy it was found that the injury exclusively involved corpus spongiosum. He subsequently underwent a penile exploration and repair of the spongiosal defect. At one year follow up, he had normal erections with no per-urethral bleed. This is a rare form of presentation of penile fractures with only a few cases reported in literature. Surgical exploration remains the gold standard and early exploration is recommended to avoid erectile dysfunction, corporal fibrosis and urethral strictures and MRI is an useful adjunct.

scholarly journals The Diagnostic Role of Urinary N-Acetyl-β-D-glucosaminidase (NAG) Activity in the Detection of Renal Tubular Impairment

2005 ◽  
Vol 48 (2) ◽  
pp. 75-80 ◽  
Author(s):  
Sylva Skálová
Keyword(s):  
Renal Damage ◽  
Perinatal Asphyxia ◽  
Non Invasive ◽  
Diagnostic Role ◽  
Invasive Method ◽  
Nephrotoxic Drugs ◽  
Renal Tubular

The kidney function can be assessed by a number of methods. The urinary excretion of enzymes, in particular N-acetyl-β-D-glucosaminidase (NAG), is considered a relatively simple, cheap, fast and non-invasive method in the detection and follow-up of renal tubular function under various conditions. The determination of urinary NAG provides a very sensitive and reliable indicator of renal damage, such as injury or dysfunction due to diabetes mellitus, nephrotic syndrome, inflammation, vesicoureteral reflux, urinary tract infection, hypercalciuria, urolithiasis, nephrocalcinosis, perinatal asphyxia, hypoxia, hypertension, heavy metals poisoning, treatment with aminoglycosides, valproate, or other nephrotoxic drugs. This paper gives an overview of the current use of urinary NAG in the detection of renal injury.

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