scholarly journals Fine-needle aspiration to improve diagnosis of melioidosis of the head and neck in children: a study from Sarawak, Malaysia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anand Mohan ◽  
Yuwana Podin ◽  
Da-Wei Liew ◽  
Jeevithaa Mahendra Kumar ◽  
Peter Sie-Teck Lau ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Head And Neck ◽  
Fine Needle Aspiration ◽  
Case Fatality ◽  
Needle Aspiration ◽  
Culture Methods ◽  
Cervical Lymph Nodes ◽  
Fine Needle ◽  
Clinical Presentations ◽  
Standard Culture

Abstract Background Melioidosis, the infection caused by Burkholderia pseudomallei, is associated with a high case fatality rate, due in part to difficulties in clinical recognition and diagnostic confirmation of the disease. Although head and neck involvement is common in children, specific disease manifestations differ between geographic regions. The aim of this study was to provide a detailed description of melioidosis of the head and neck among children in Sarawak, Malaysia, and determine if fine-needle aspiration of suspected head or neck lesions could improve melioidosis diagnosis. Methods We conducted a retrospective descriptive study of all children aged < 12 years with culture-confirmed melioidosis presenting with head and neck manifestations and admitted to Bintulu Hospital in Sarawak, Malaysia, from January 2011 until December 2020. Fine-needle aspiration of head and neck lesions suspected to be due to melioidosis with inoculation in blood culture bottles (FNA + BCB) was used from the beginning of 2016. Results Of 34 children with culture-confirmed melioidosis, 20 (59%) had an infection involving one or more sites in the head and neck. Of these, 17 (85%) were diagnosed in or after 2016. Cervical lymph nodes were the most common organ or site affected, involved in 19 (95%) children. Clinical presentations of B. pseudomallei lymph node infections were highly variable. Five (25%) children had salivary gland involvement. Lacrimal gland involvement (dacryocystitis) and skin or soft tissue infection (scalp abscess) were less frequent. B. pseudomallei was isolated from the head or neck using FNA + BCB in 15 (75%) children and by standard culture methods of direct plating of pus on agar following incision and drainage in only 2 (10%) children. B. pseudomallei was isolated from non-head or neck specimens or blood in 3 (15%) children. Conclusions Manifestations of pediatric head and neck melioidosis in Sarawak, Malaysia, differ from those of other regions. Fine-needle aspiration, mainly of affected cervical lymph nodes, facilitates B. pseudomallei detection and enables confirmation of melioidosis infections.

scholarly journals Evaluation of the efficacy of ultrasound in the diagnosis of cervical lymphadenopathy

2018 ◽  
Vol 30 (3) ◽  
pp. 59-67
Author(s):  
Shahad D Ali ◽  
Taghreed F Zaidan ◽  
Mohammed A Mahdi
Keyword(s):  
Lymph Nodes ◽  
Clinical Evaluation ◽  
Fine Needle Aspiration ◽  
Cervical Lymphadenopathy ◽  
Needle Aspiration ◽  
High Accuracy ◽  
Surrounding Tissue ◽  
Cervical Lymph Nodes ◽  
Fine Needle ◽  
Malignant Lymph Nodes

Background: Cervical lymph nodes are prone to involved by a number of pathologic processes. They are common sites for lymphoma, metastasis, and reactive enlargement in a number of conditions. Aims of the study:-Clinical evaluation of patients with cervical lymphadenopathy. Differentiation between benign and malignant lymph nodes by means of ultra sounds (US) and Correlate the US findings with cytological and/or histopathological findings of cervical lymph nodes. Subjects, Materials and Methods:-The present study was carried out over a period of 6 months and included 81 patients of different age groups presenting with cervical lymphadenopathy. Each patient was examined clinically, then comprehensive sonographic examination of the neck for cervical lymph nodes (L.Ns) was performed using ultrasound machine (GE Wipro Proseries). The scanning was performed with the patient in the supine position, and with the neck hyperextended using a pad or pillow under the shoulders in order to provide optimum exposure of the neck. The parameters considered in this study include: site, long axis (L), short axis (S), shape index (S/L), echotexture, margins, ancillary features like calcification, necrosis, matting and surrounding tissue changes. These findings were correlated with fine-needle aspiration cytology, core and excisional biopsy. The nodes were classified as benign (reactive) and malignant (lymphomatous and metastatic). Results: The age of patients ranged from five to seventy five years, they were 45 male and 36 females, there was association between family history and development of malignant lesions. Regarding clinical evaluation, and according to consistency, (13) hard L.Ns were malignant and (1) was benign, (27) rubbery L.Ns were malignant and 40 soft L.Ns were benign. According to fixation to underlying structure, forty one L.Ns were fixed, (40) were malignant and (1) was benign. Forty L. Ns were not fixed, on histopathological evaluation all were benign. On US, the results showed that malignant lymph nodes are mostly appeared as round shape, homogenous echotexture, nodal shape (S/L ratio) accurate for differentiating benign from malignant lymph nodes. Most of the malignant nodes had well-defined borders. Calcifications, necrosis, matting, were characteristically found in benign lymph node. A combined ultrasound-guided and fine-needle aspiration (FNA) diagnosis had a high accuracy as compared with situations in which they were used alone. Conclusions: Sonographic findings have a high accuracy in differentiating benign from malignant cervical lymph nodes. An ultrasound scan can be used as the first-line imaging tool in the diagnostic evaluation of cervical lymphadenopathy. Using gray scale features are particularly useful to identify the causes of cervical lymphadenopathy.

scholarly journals Association of Ultrasonography and Ultrasound-guided Fine Needle Aspiration Cytology in the Diagnosis of Thyroid Nodules

2021 ◽  
Vol 6 (2) ◽  
pp. 1573-1578
Author(s):  
Binit Dev ◽  
Ajay Kumar Yadav ◽  
Sushil Taparia ◽  
Roshana Khadka ◽  
Shripad J Walavalkar
Keyword(s):  
Lymph Nodes ◽  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Ultrasound Guided ◽  
Aspiration Cytology ◽  
Cervical Lymph Nodes ◽  
Fine Needle ◽  
Needle Aspiration Cytology ◽  
Benign Nodules

Introduction: Ultrasound (USG) is the most commonly used imaging method to evaluate thyroid nodules. The sonographic features of thyroid nodules are very important to determine whether the nodule is benign or malignant. Fine Needle Aspiration Cytology (FNAC) is the gold standard to determine whether the nodule is benign or malignant. Objective: The purpose of this study was to compare ultrasound and color Doppler features of thyroid nodules with ultrasound-guided FNAC results to determine the relative importance of these features in predicting the risk of malignancy. Methodology: This prospective cross-sectional study was conducted in Birat medical college teaching hospital in Tankisinuwari, Morang, Nepal. The study was conducted from September 2019 to April 2021.  In total sixty-one patients with thyroid nodules were evaluated for sonographic characteristics. Finally, USG guided FNA for cytopathological examination was performed. Both descriptive and inferential statistics were used to analyze the result. Results: Out of the 61 patients, 34 (55.7%) were females and 27 (44.2%) were males. Majority of the malignant nodules were solid 11 (91.6%), whereas cystic and mixed nodules were predominantly seen in benign nodules 18 (36.7%) and 30 (61.2%) respectively. In malignant nodules 10 (83.3%) were heterogeneous and 2 (16.6%) were isoechoic. In benign nodules 29 (59.1%) were heterogeneous and 15 (30.6%) were anechoic with comet-tail artifact and 5 (10.2%) were isoechoic. Among 12 malignant cases, internal and peripheral vascularity were equally present in six cases each. Benign nodules showed peripheral vascularity in 48 (97.9%) and internal vascularity was noted in only one nodule. All of the malignant nodules showed calcification. None of the benign nodules showed micro-calcification. In malignant cases, cervical lymph nodes were present in 7 (58.3%) and absent in 5 (41.6%). In benign cases, cervical lymph nodes were present in 4 (8.1%) and absent in 45 (91.83%). Conclusion: The ultrasound features associated with malignancy in thyroid nodules are predominantly solid component, presence of micro-calcifications and internal vascularity. Enlarged cervical lymph nodes are good predictors for malignancy. USG guided FNAC confirms the suspicious features of thyroid nodules seen on USG.

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