Comparative analysis of accuracy of diagnosis of chronic periapical lesions made by clinical and histopatological examination

Introduction. The preliminary diagnosis of chronic periapical lesions is made on the basis of clinical symptoms and radiographs, which is a reliable diagnostic tool, but it has only a subsidiary role since histopathological verification is essential for the definitive diagnosis. This study was aimed at diagnosing removed chronic periapical lesions and classifying them by size as well as at comparing the clinical diagnoses with histipathological results. Material and Methods. The study included 34 patients diagnosed with chronic periapical process by applying clinical examination and radiography. The removed chronic periapical lesions were processed according to classical histological technique and analyzed by hematoxylin and eosin staining protocol. Results. According to histopathological analysis 53% of chronic periapical lesions were periapical granulomas and 47% were radicular cysts. The size of the lesions ranged from < 9 mm (70% of lesions), 9 to 20 mm (18% of lesions) and > 20 mm (12% of lesions).The histopathological examination revealed that clinical diagnosis was wrong in 26% of cases. Conclusion. A statistically significant difference between clinical and histopathological diagnosis has been found. The histopathological findings strongly suggest the necessity of complete curettage of lesions sizing > 20 mm in order to prevent recurrences.

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Suicide by intoxication with iron (III) chloride

Forensic Toxicology ◽

10.1007/s11419-021-00579-6 ◽

2021 ◽

Author(s):

Sławomir Majdanik ◽

Barbara Potocka-Banaś ◽

Sebastian Glowinski ◽

Krzysztof Borowiak

Keyword(s):

Prussian Blue ◽

Chloride Ions ◽

Iron Chloride ◽

Histopathological Analysis ◽

Fatal Intoxication ◽

Internal Organs ◽

Specific Staining ◽

Iron Supplements ◽

Staining Protocol ◽

Hematoxylin And Eosin

Abstract Purpose Cases of iron intoxication are not very often encountered in toxicology practice, and most of those reported concern accidental intoxications with iron supplements in young children. The paper presents a rare case of a suicide by intoxication in an adult woman who ingested a solution of iron (III) chloride. Methods A forensic was at the Department of Forensic Medicine, PMU in Szczecin. Toxicology tests of blood sampled from the deceased were performed using a 644 CIBA CORNING ion selective analyzer and proprietary reagent kits. Histopathological was with the use of the standard staining protocol (hematoxylin and eosin) and staining specific for iron (Prussian blue). Results Autopsy revealed a distinct yellow discolouration and thrombotic necrosis of the oral mucosa and almost the whole gastrointestinal tract, as well as similar changes in the adjacent internal organs. Considerably high levels of iron and chloride ions were detected in specimens of internal organs preserved during autopsy. Histopathological analysis performed with the use of staining specific for iron (Prussian blue) also confirmed the presence of iron in the examined tissues, especially in the intestines and liver. Conclusions Considering the above findings, it was concluded in the forensic report that the death of the woman was caused by the ingestion of iron chloride. The reported case of fatal intoxication is one of the few described in the literature, and its course implies that in the case of initially diagnosed intoxication with corrosive compounds, the possibility of using metal-containing poison should also be considered in the differential diagnosis. In addition to routine toxicological tests performed in fatal cases we also draw attention to the possibility of using specific staining protocols for microscopic specimens.

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Retrospective liver histomorphological analysis in dogs in instances of clinical suspicion of congenital portosystemic shunt

Journal of Veterinary Research ◽

10.2478/jvetres-2019-0026 ◽

2019 ◽

Vol 63 (2) ◽

pp. 243-249 ◽

Cited By ~ 1

Author(s):

Małgorzata Sobczak-Filipiak ◽

Józef Szarek ◽

Iwona Badurek ◽

Jessica Padmanabhan ◽

Piotr Trębacz ◽

...

Keyword(s):

Portal Vein ◽

Developmental Disorders ◽

Clinical Symptoms ◽

Histopathological Examination ◽

Vascular Anomaly ◽

Clinical Suspicion ◽

Diagnostic Process ◽

Histopathological Analysis ◽

Portosystemic Shunts ◽

Vascular Connections

AbstractIntroduction: The clinical symptoms of portosystemic shunts (PSSs) and hepatic microvascular dysplasia (HMD) – portal vein hypoplasia (PVH) in dogs are similar. PSSs are abnormal vascular connections between the portal vein system and systemic veins. HMD is a very rare developmental vascular anomaly, recognisable during histopathological examination. The study aim was to assess the prevalence of HMD–PVH and hepatocellular and vascular pathologies in the liver. Material and Methods: Liver biopsies from 140 dogs (of different breeds and both sexes) arousing clinical suspicion of PSS were examined histopathologically. Results: An initial PSS diagnosis was confirmed in 125 dogs (89.29%). HMD–PVH was found in 12.32% of dogs, as an isolated disease in 9.29%, especially in Yorkshire terriers, and with extrahepatic PSS in 6.67%. Histopathological analysis of muscles around sublobular veins showed that HMD cases presented hypertrophy or hypertrophy with fibrosis. In 2.17% of all dogs with liver vascular developmental disorders calcification was visible around vessels (without correlation by degenerative changes in those vessels), suggesting prior onset of deep metabolic disorders. Clinical suspicion of PSS was also formed upon quite different pathological processes in young dogs. Conclusion: Histopathological findings diagnosed the type of vascular anomalies (PSS or HMD–PVH) or other pathological changes conclusively, therefore detailed hepatic histopathology is an indispensable component of the clinical diagnostic process.

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Clinicopathological study of testicular lesions

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20191346 ◽

2019 ◽

Vol 7 (4) ◽

pp. 1319

Author(s):

Manjusha Dhawle ◽

Ashwini Tangde ◽

Anil Joshi ◽

Rajan Bindu

Keyword(s):

Clinical Symptoms ◽

Histopathological Examination ◽

Clinical History ◽

Testicular Atrophy ◽

Histopathological Diagnosis ◽

Common Complaint ◽

Neoplastic Lesion ◽

Testicular Abscess ◽

Neoplastic Lesions ◽

Testicular Lesions

Background: Testis is affected by both neoplastic and non neoplastic conditions. Non neoplastic lesions of the testis include epididymo-orchitis, testicular atrophy, undescended testis, testicular abscess etc. Testicular tumors are relatively rare. They constitute the 4th most common cause of death from neoplasia in the young males. This study was undertaken to study the histopathological spectrum, age wise distribution and clinical symptoms of testicular lesions.Methods: This is a retrospective study of three years conducted in the department of pathology, Aurangabad from June 2015 to May 2018. It included all the orchidectomy specimens received from the department of surgery and excluded the orchidectomy specimens sent for infertility and prostatic carcinoma. A detail clinical history was taken. Histopathological examination was done after routine processing and staining with H and E. The data collected was tabulated, analysed and compared to other similar studies.Results: We studied 70 cases. Non neoplastic testicular lesions were 57 and 13 were neoplastic. Non neoplastic testicular lesions were more common than the neoplastic ones. Non neoplastic testicular lesions presented most commonly in the 2nd decade. Most common non neoplastic lesion was epididymo-orchitis followed by torsion, atrophy and testicular abscess. Most common neoplasm was malignant mixed germ cell tumor. Most of the patients of neoplasms presented in the 3rd decade. The most common complaint was testicular swelling and pain.Conclusions: Majority of testicular lesions are non neoplastic. Neoplastic lesions are rare. Non neoplastic lesions mimic neoplastic ones clinically, as testicular swelling is the most common complaint. So histopathological diagnosis is necessary for an accurate diagnosis of testicular lesions.

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Histomorphological analysis and clinical correlation of neoplastic and non neoplastic skin lesions: a study in a tertiary care centre of Western Uttar Pradesh, India

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20203093 ◽

2020 ◽

Vol 8 (8) ◽

pp. 2820

Author(s):

Mithila Bisht ◽

Anjana Arya ◽

B. C. Choudhry

Keyword(s):

Histopathological Examination ◽

Tertiary Care ◽

Uttar Pradesh ◽

Skin Lesions ◽

Punch Biopsy ◽

Histopathological Analysis ◽

Histopathological Diagnosis ◽

Tertiary Care Centre ◽

Male Predominance ◽

Dermatological Disorders

Background: Clinical examination may suffice in making diagnosis of most dermatologic disorders but histopathological examination is often required to confirm the diagnosis and further categorize the lesions. Authors carried out this study to analyse the demographic and histomorphological characteristics of skin lesions, to determine the frequency of various dermatological disorders in the region and to evaluate the agreement between clinical and histopathological diagnosis.Methods: Punch biopsies of skin lesions received in histopathology section, were included in the study. Cases over a period of six months were analysed. Clinical details were recorded and histopathological analysis done. Special stains were applied wherever required.Results: Of the 120 cases studied, maximum cases fell in the category of 31-40 years, with male predominance. Authors observed wide variety of non-neoplastic and neoplastic lesions. Infectious diseases were the most common of all pathologies. Leprosy was the most common histopathological diagnosis. Complete clinicopathologic correlation was seen in 51.67% of cases while partial correlation was noted in 23.33% making a total of 75%. 25% histopathological diagnosis were inconsistent with the clinical diagnosis.Conclusions: Histopathology is a gold standard investigation and plays a very important role in confirmation of clinical diagnosis of various skin lesions. Punch biopsy is a relatively easy outpatient procedure to perform.

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Concentration of Transforming Growth Factor-beta 1 in Chronic Periapical Lesions / Ispitivanje koncentracije transformišućeg faktora rasta beta 1 u hroničnim periapeksnim lezijama

Acta Facultatis Medicae Naissensis ◽

10.1515/afmnai-2015-0004 ◽

2015 ◽

Vol 32 (1) ◽

pp. 43-49 ◽

Cited By ~ 1

Author(s):

Jelena Popović ◽

Tatjana Cvetković ◽

Tanja Džopalić ◽

Aleksandar Mitić ◽

Marija Nikolić ◽

...

Keyword(s):

Transforming Growth Factor Beta ◽

Transforming Growth Factor ◽

Clinical Symptoms ◽

Periapical Lesion ◽

Periapical Lesions ◽

Three Samples ◽

Significant Difference ◽

Tissue Homogenates ◽

Growth Factor Beta ◽

The Difference

Summary Host response to antigen stimulation in chronic inflammatory periapical lesions is mainly controlled by the balance between proinflammatory and anti-inflammatory cytokines. The aim of this study was to determine the concentration of TGF-β1 in the tissue homogenates of periapical lesions and to analyse its level in relation to the symptomatology of the patients and size of the lesions. Ninety three samples of chronic periapical lesions were obtained after extraction of teeth. Samples were divided according to the clinical symptoms as symptomatic and asymptomatic, and according to the size as large and small. The concentration of TGF-β1 was analyzed using ELISA. The results showed increased production of TGF-β1 in symptomatic lesions compared to asymptomatic, but the difference was not statistically significant. Statistically significant difference in TGF-β1 concentrations was observed in large lesions compared to small (p<0,001). It seems that TGF-β1 have a modulating effect on bone tissue resorption activity under the influence of proinflammatory cytokines and can be molecular prognostic marker of periapical lesion healing.

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Study of Correlation of Preoperative Fine Needle Aspiration Cytology with Histopathological Examination in Thyroid Swellings

International Journal of Phonosurgery & Laryngology ◽

10.5005/jp-journals-10023-1135 ◽

2017 ◽

Vol 7 (1) ◽

pp. 16-19

Author(s):

Sri Lekha Bodepudi ◽

KASSN Kalyan ◽

Ramarao Peddi

Keyword(s):

Fine Needle Aspiration ◽

Fine Needle Aspiration Cytology ◽

Histopathological Examination ◽

Needle Aspiration ◽

Histopathological Analysis ◽

Histopathological Diagnosis ◽

Aspiration Cytology ◽

Fine Needle ◽

Thyroid Swelling ◽

Needle Aspiration Cytology

ABSTRACT Introduction Though fine needle aspiration cytology (FNAC) for thyroid is acclaimed as a gold standard before going for intervention, there are some limitations with respect to tissue availability, technique, skill of performer, etc. So, a cross-sectional study was conducted to determine the accuracy of FNAC in diagnosis of thyroid swelling and to assess the correlation between preoperative cytopathological diagnosis and postoperative histopathological diagnosis. Materials and methods Data collected from records in the time period of 3 years, i.e., from August 2012 to August 2015, were evaluated and analyzed. Results A total number of 93 cases were included in the study of which majority were females with frequency of 84.94%, most of the incidence of thyroid swellings occur in the age group of 40 to 50 years. Overall mismatch between histopathological examination and FNAC was 43 out of 93 and of which 7 were major and 36 were minor mismatch. Sensitivity of patients having malignancy with positive FNAC is 82.35% from the study and specificity of patients with nonmalignant thyroid disease and positive cytology is 95.18%. Conclusion It was observed that FNAC is a reliable, safe, and accurate method as a first line of evaluation in thyroid swelling before the surgery. Fine needle aspiration cytology is more sensitive in detecting thyroid gland malignancy but still correlation is always necessary and therefore, histopathological analysis still remains essential for final diagnosis. How to cite this article Bodepudi SL, Kalyan KASSN, Peddi R. Study of Correlation of Preoperative Fine Needle Aspiration Cytology with Histopathological Examination in Thyroid Swellings. Int J Phonosurg Laryngol 2017;7(1):16-19.

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A Rare Case of Angiofibroma Mimicking Fibrous Epulis in Posterior Gingival Mucosa

Acta Medica Philippina ◽

10.47895/amp.v55i8.2128 ◽

2021 ◽

Vol 55 (8) ◽

Author(s):

Annete Nabila ◽

Ni Putu Mira Sumarta ◽

Okky Prasetio

Keyword(s):

Rare Case ◽

Histopathological Examination ◽

Excisional Biopsy ◽

Definitive Diagnosis ◽

Benign Tumors ◽

Histopathological Analysis ◽

Clinical Appearance ◽

Gingival Mucosa ◽

The Right ◽

Superficial Soft Tissue

Angiofibromas are highly vascular, locally aggressive but histologically benign tumors. A 40-year-old woman complaint of pedunculated mass in the right gingiva of the posterior region since 7 months earlier. Surgical excisional biopsy under general anesthesia was performed. Histopathological examination showed an angiofibroma. Angiofibromas are localized in the superficial soft tissue and the gingiva could have a similar clinical appearance as an epulis. Definitive diagnosis was determined through histopathological analysis.

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Spectrum of Oral Cavity Lesions and its Clinico-Histopathological Correlation

Nepal Journal of Health Sciences ◽

10.3126/njhs.v1i2.42378 ◽

2021 ◽

Vol 1 (2) ◽

pp. 42-47

Author(s):

Deepshikha Gaire ◽

Anil Dev Pant ◽

Daisy Maharjan ◽

Usha Manandhar

Keyword(s):

Risk Factors ◽

Oral Cavity ◽

Clinical Presentation ◽

Histopathological Examination ◽

Wide Spectrum ◽

Malignant Lesion ◽

Histopathological Diagnosis ◽

Cross Sectional ◽

Gold Standard Method ◽

Clinical Diagnoses

Introduction: Oral cavity lesions comprise a wide spectrum of diseases that varies from non-neoplastic to neoplastic. The clinical evaluation alone is insufficient for proper diagnosis in most cases. So, histopathological examination is the gold standard method for diagnosis and management of patients accordingly. Objective: The present study was done to evaluate the histopathological spectrum of oral cavity lesions and compare them in relation to age, sex, site, clinical features, risk factors, and clinical diagnoses. Methods: This prospective cross-sectional study enrolled 127 cases of oral biopsies which were received at the Department of Pathology, Tribhuvan University and Teaching Hospital, Kathmandu Nepal, from May 2018 to April 2019 for histopathological examination. Specimens were fixed in 10% formalin and subjected for tissue processing and Hematoxylin and Eosin stained sections. Data entry and analysis were done by using SPSS 24 version where frequency and percentile were calculated. Results: Total cases were 127 with slight female predilection and the age group of 50-60 years (mean age of 44.24 years) were commonly affected. The tongue being the most common site, frequently lesions presented as swelling. Most of the lesions were non-neoplastic comprising 45% whereas malignant lesions comprised 23.6%. Smoking increased the risk of malignancy by 2 fold. The most common benign lesions were squamous papilloma & fibroepithelial polyp whereas the malignant lesion was squamous cell carcinoma. Sixty percent of clinical diagnoses didn’t show correlation. Conclusions: Oral cavity lesions have a wide spectrum of distribution in age, sex, site, and clinical presentation. Initially, oral lesions may present with subtle symptoms which may cause underdiagnosis. Thus, histopathological diagnosis is a must to rule out malignancy. Keywords: Clinical presentation; correlation; oral cavity; risk factors.

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Necessity of routine histopathological examination of gall bladder specimens after elective cholecystectomy: An experience at Tertiary Care Hospital of Southern Punjab Pakistan

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.06.3846 ◽

2020 ◽

Vol 27 (06) ◽

pp. 1171-1175

Author(s):

Sadaf Shafique ◽

Raheel Khan ◽

Raees Abbas ◽

Bakhtawer Mehmood

Keyword(s):

Gall Bladder ◽

Histopathological Examination ◽

Tertiary Care ◽

Pathological Examination ◽

Histopathological Analysis ◽

Histopathological Diagnosis ◽

Care Hospital ◽

Benign Diseases ◽

Selective Approach ◽

Elective Cholecystectomy

Objectives: Few centers adopt a selective approach in sending these specimens to pathology department for histopathology whereas it is a routine procedure in our setup. In our study, few unexpected cases of adenocarcinoma of gall bladder were seen during investigation of results of pathological examination of gall bladder specimens. Study Design: A retrospective histopathological analysis of gall bladder specimens removed during elective cholecystectomy for benign diseases was done. Setting: Department of Pathology, Quaid-e-Azam Medical College/Bahawal Victoria Hospital Bahawalpur. Period: 1st January 2018 to 31st December 2018. Material & Methods: The demographic properties of the patients were evaluated from the past records and their association was seen with the histopathological diagnosis and frequency of unexpected cases of gall bladder carcinoma. Results: Total of 840 cases were reviewed with mean age of the patient 42.48±14.8 years. The most frequent diagnosis was chronic cholecystitis with cholelithiasis (n=806) which was associated with upper abdominal pain (p<0.01). It was more prevalent among females sex (n=742). Six patients (0.7%) showed evidence of adenocarcinoma of gall bladder which had no gross abnormality on macroscopic examination. Conclusion: It is very significant to do routine histopathological examination of all the gall bladder specimens removed for benign diseases during elective cholecytectomies which incidentally may also be associated with carcinoma gall bladder and may require further surgical intervention.

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Clinicohistopathological Correlation in Leprosy

Kathmandu University Medical Journal ◽

10.3126/kumj.v9i4.6338 ◽

2012 ◽

Vol 9 (4) ◽

pp. 248-251 ◽

Cited By ~ 3

Author(s):

M C Mathur ◽

R B K Ghimire ◽

P Shrestha ◽

S K Kedia

Keyword(s):

Infectious Disease ◽

Clinical Diagnosis ◽

Histopathological Examination ◽

Mycobacterium Leprae ◽

P Value ◽

Histopathological Diagnosis ◽

Common Infectious Disease ◽

Clinical Diagnoses ◽

Leprosy Patients ◽

Skin Biopsies

Background Leprosy is a chronic, infectious disease caused by Mycobacterium leprae. It is classified into five groups based on clinical, histological, microbiological and immunological criteria (Ridley & Jopling Classification). However, a great variation has been observed in the interpretation of histopathological examination ok skin biopsies and clinical presentation of the disease. Objective To correlate clinical diagnosis with histopathological diagnosis of leprosy patients in Nepal. Methods A retrospective hospital-based study was conducted among patients with all clinical types of leprosy, classified as per the Ridley-Jopling classification. Skin biopsies were taken from active lesions in all patients and were stained with Hematoxylin & Eosin stain and modified Fite-Ferraco stain for identification of Mycobacterium leprae. The histopathological findings were compared with clinical diagnoses. Results A total 156 patients were studied, out of which 84 (53.8%) males and 72 (46.1%) females between 8 and 86 years of age. The majority of patients 33 (23.57%) were in the age group of 21-30 years and least affected was children below 10 years 1(0.007%).Overall coincidence of clinical and histopathological diagnoses of classification was seen in 115 cases (80.4%). The maximum correlation (95.2%) was noted in LL patients (p value 0.000049) followed by BT(89.74%), TT (73.2%), BL(72.4%), BB(64.7%). Conclusion Leprosy still continues to be one of the common infectious disease in Nepal and skin biopsy is a useful tool in confirming the clinical diagnosis of leprosy as well as for the therapeutic guide. DOI: http://dx.doi.org/10.3126/kumj.v9i4.6338 Kathmandu Univ Med J 2011;9(4):248-51

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