scholarly journals Cytomorphological spectrum of metastatic bone tumors: Experience at a tertiary care center

CytoJournal ◽  
2022 ◽  
Vol 19 ◽  
pp. 1
Author(s):  
Shruti Gupta ◽  
Nirmalya Banerjee ◽  
Parikshaa Gupta ◽  
Manish Rohilla ◽  
Nalini Gupta ◽  
...  
Keyword(s):  
Bone Tumors ◽  
Malignant Tumors ◽  
Care Center ◽  
Tertiary Care ◽  
Primary Source ◽  
Clinical History ◽  
Needle Aspiration ◽  
Skeletal Metastases ◽  
Male Preponderance ◽  
Breast And Prostate Cancer

Objectives: Bone is a frequent site of metastases and typically indicates a short-term prognosis in cancer patients. The majority of skeletal metastases are due to breast and prostate cancer. Bone metastasis is actually much more common than primary bone cancers, especially in adults. Fine-needle aspiration cytology (FNAC) provides reasonably accurate pre-operative diagnosis in vast majority of cases. This study aims to elicit the cytomorphological detail of various metastatic bone tumors. Material and Methods: A total of 109 cases of tumors metastatic to bone have been included in this study. The details of the cases were available from the archives of the department of cytology. May Grunwald Giemsa and hematoxylin and eosin stained smears were studied and examined for the cytomorphological spectrum. Cell block and immunohistochemistry tests were done, wherever feasible. Results: Among 109 patients, the mean age was 54.52 years. There was male preponderance with 90 males and 19 females. The most common site of metastases was in the vertebra (82 cases), and 76 cases were in the dorsolumbar region. The most common type of tumor metastasizing was adenocarcinoma. Conclusion: FNAC is a very useful, economical procedure. There are characteristic cytological features of the metastatic lesions and the basic diagnostic categorization of the malignant tumors is possible on FNAC. Regarding the primary source clinical history, radiological features of the primary tumor, if any, and immunocytochemistry may be needed.

A comparison between 25-gauge and 22-gauge Franseen needles for endoscopic ultrasound-guided sampling of pancreatic and peripancreatic masses: a randomized non-inferiority study

Endoscopy ◽  
2021 ◽  
Author(s):  
Dongwook Oh ◽  
Joonseog Kong ◽  
Sung Woo Ko ◽  
Seung-Mo Hong ◽  
Hoonsub So ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Endoscopic Ultrasound ◽  
Care Center ◽  
Tertiary Care ◽  
Standard Of Care ◽  
Fine Needle Biopsy ◽  
Needle Aspiration ◽  
Adverse Event Rate ◽  
Current Standard ◽  
Fine Needle

Abstract Background Endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) and fine-needle biopsy (FNB) are the current standard of care for sampling pancreatic and peripancreatic masses. Recently, a 22G EUS-FNB needle with Franseen geometry was developed, and this device was also introduced in a 25G platform. We compared the performance of the 25G and 22G Franseen needles for EUS-guided sampling of pancreatic and peripancreatic solid masses. Methods We conducted a parallel-group randomized non-inferiority trial at a tertiary-care center from November 2018 to May 2019. The primary outcome was the quality of the histologic core assessed using the Gerke score. The optimal histologic core is indicated by a Gerke score of 4 or 5, which enables optimal histologic interpretation. The overall diagnostic accuracy and adverse event rate were also evaluated. Results 140 patients were enrolled and randomized (1:1) to the 25G and 22G groups. Tissue acquisition by EUS-FNB was successful in all patients. The optimal histologic core procurement rate was 87.1 % (61/70) for the 25G needle vs. 97.1 % (68/70) for the 22G; difference −10 % (95 % confidence interval −17.35 % to −2.65 %). High quality specimens were more frequently obtained in the 22G group than in the 25G group (70.0 % [49/70] vs. 28.6 % [20 /70], respectively; P < 0.001). The overall diagnostic accuracy did not differ between the groups (97.4 % for 25G vs. 100 % for 22G). Conclusions The 25G Franseen needle was inferior to the 22G needle in histologic core procurement. Therefore, for cases in which tissue architecture is pivotal for diagnosis, a 22G needle, which procures relatively higher quality specimens than the 25G needle, should be used.

scholarly journals Characteristics of Patients with Colonic Polyps Requiring Segmental Resection

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Robert A. Mitchell ◽  
Chaoran Zhang ◽  
Cherry Galorport ◽  
Blair Walker ◽  
Jennifer Telford ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Colonic Polyps ◽  
Clinical History ◽  
Colon Resection ◽  
Segmental Resection ◽  
Polyp Size ◽  
New Techniques ◽  
Endoscopic Techniques ◽  
The Mean

Background. It is unclear if the availability of new techniques for removal of large colonic polyps has affected the use of segmental colon resection. We sought to evaluate the characteristics of polyps undergoing surgical resection, including involvement of therapeutic gastroenterologists (TG). Methods. 484 patients had a colonic resection; 165 (34%) were identified from the pathology database with polyp, adenoma, or mass in the clinical history field; these charts were reviewed. Results. 128 patients (mean age 68 yrs, 72% male) were included. The mean polyp size was 2.9 cm (0.4 cm–12.0 cm). Adenocarcinoma was diagnosed in 50 (39.1%). 97 (75.8%) patients had a polyp that was felt to be unresectable by EMR, and 31 (24.2%) underwent successful EMR followed by surgery for adenocarcinoma (n=29). The indication for surgery in those with unresectable polyps was variable and was not clearly documented in 51 (52.6%); only 17 of these patients (17.5%) had a TG involved. Conclusion. A high proportion of polyps managed by segmental resection did not contain adenocarcinoma. This data suggests that even in a tertiary care center where advanced endoscopic techniques are easily available, they are not always utilized. Educational endeavors to ensure that ideal pathways of intervention are utilized require implementation.

scholarly journals Clinical profile of cases of dysphagia presenting in ENT department: a study from rural tertiary care center

2017 ◽  
Vol 3 (3) ◽  
pp. 639
Author(s):  
Ginni Datta ◽  
Manish Gupta ◽  
Naiya Rao
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Clinical Problem ◽  
Needle Aspiration ◽  
Clinical Profile ◽  
Barium Swallow ◽  
Tertiary Care Centre ◽  
Predominant Symptom ◽  
Alarm Symptom ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> Swallowing is a complex motor reflex requiring coordination among the neurologic system and muscles of the oropharynx and oesophagus. Disorders both benign and malignant may interfere with the process and cause dysphagia. We hereby undertake a study in a rural tertiary care centre to study the clinical profile of cases of dysphagia and to find the relative incidence of various etiologies of dysphagia.</p><p class="abstract"><strong>Methods:</strong> A prospective study was conducted upon both out and indoor patients coming to Department of Otorhinolaryngology from January 2016 to January 2017 with predominant symptom of difficulty in swallowing for both solids, liquids or either. Detailed history &amp; examination was done. Further endoscopy, barium swallow, fine needle aspiration cytology (FNAC) &amp; biopsies were done as required. A total of 140 cases were taken into consideration.  </p><p class="abstract"><strong>Results:</strong> The mean age was 52.5 years with 60% patients males and 40% females. The commonest etiology of dysphagia was Gastroesophageal reflux disease (GERD) occupying 28.57%of cases. Among them 65% werefemales majority in the age group of 45-55 years. The 2<sup>nd</sup> common cause of dysphagia was growth pharynx 18.5% of cases. Among them 19 cases were diagnosed as growth oropharynx and 7 cases as growth supraglottis extending to hypopharynx. 88.46% were males and all were smokers. The 3<sup>rd</sup> common etiology of dysphagia was obstructive oesophageal causes which included oesophageal malignancies, oesophageal webs, strictures and diverticula in the frequency of 16%, 3%, 3% and 6% respectively. Oesophageal malignancies were mainly adenocarcinoma, all males who were chronic smokers.</p><p><strong>Conclusions:</strong> Dysphagia is a commonly encountered clinical problem &amp; limited studies exist regarding the prevalence of dysphagia etiologies. It is an alarm symptom, malignancy should be ruled out, and warrants early intervention. </p>

Risks of Neoplasia and Malignancy in Surgically Resected Cystic Parotid Lesions

2019 ◽  
Vol 162 (1) ◽  
pp. 79-86
Author(s):  
Brian C. Boursiquot ◽  
Nancy J. Fischbein ◽  
Davud Sirjani ◽  
Uchechukwu C. Megwalu
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Needle Aspiration ◽  
Cross Sectional Study ◽  
Preoperative Imaging ◽  
Cross Sectional ◽  
Risk Of Malignancy ◽  
History Of ◽  
Diagnostic Samples ◽  
Cystic Masses

Objectives To evaluate the risks of neoplasm and malignancy in surgically treated cystic parotid masses compared with solid or mixed lesions and to evaluate the performance of fine-needle aspiration (FNA) in parotid cysts. Study Design Retrospective cross-sectional study. Setting Single-institution academic tertiary care center. Subjects and Methods Patients without a history of human immunodeficiency virus or head and neck cancer who underwent parotidectomy for parotid masses and had preoperative imaging to characterize lesions as cystic, solid, or mixed (ie, partially cystic and partially solid). We assessed the risks of neoplasia and malignancy, adjusting for age, sex, race/ethnicity, facial nerve weakness, and history of malignancy. We also evaluated the sensitivity and specificity of FNA. Results We included 308 patients, 27 of whom had cystic parotid masses (5 simple and 22 complex). Cystic masses were less likely to be neoplastic compared to solid or mixed masses (44% vs 97%; odds ratio [OR], 0.03; 95% confidence interval [CI], 0.01-0.07); however, there was no difference in the risk of malignancy (22% vs 26%; OR, 0.81; 95% CI, 0.32-2.10). Cystic masses were more likely to yield nondiagnostic FNA cytology results, but for diagnostic samples, FNA was 86% sensitive and 33% specific for diagnosing neoplasia and 75% sensitive and 83% specific for diagnosing malignancy. Conclusion In our population, cystic masses undergoing surgery were less likely to be neoplastic but had a similar risk of malignancy as solid masses. The risk of malignancy should be considered in the management of cystic parotid masses.

CYTOPATHOLOGICAL SPECTRUM OF NON NEOPLASTIC AND NEOPLASTIC THYROID LESIONS AT TERTIARY CARE CENTRE, GWALIOR

2021 ◽  
pp. 13-15
Author(s):  
Sapna Dhakad ◽  
Shailendra Sharma ◽  
Diljeet Kaur
Keyword(s):  
Malignant Tumors ◽  
Tertiary Care ◽  
Diagnostic Technique ◽  
Hashimoto Thyroiditis ◽  
Needle Aspiration ◽  
Follicular Neoplasm ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Thyroid Lesion ◽  
Thyroid Lesions

Background: Thyroid lesions are the important clinical problems encountered in most of patients coming to the tertiary care centre. Fine Needle Aspiration Cytology (FNAC) is the widely accepted diagnostic technique in thyroid lesions. A solitary thyroid nodule is dened as a palpable, single, clinically detectable nodule in the thyroid. They cause more concern because of high probability of malignancy in them, which can range from 5-35% of all solitary thyroid nodules. Nodular lesion comprises those disorders that produce a clinical nodule and consists of non-neoplastic hyperplasia as well as benign and malignant tumors. Aims and Objectives:To study the spectrum of clinical presentation of individuals with thyroid lesions and cytomorphological features. Material and methods: A retrospective study was carried out in cytopathology section in Department of Pathology from January 2015 to December 2017. Total 212 patients with palpable thyroid swelling referred from the OPD of J.A hospital for FNAC were included in the study. The smears made from the aspirate were air dried and stained with May-Grunwald-Giemsa (MGG) stain. Result: The present study was carried out in the Department of Pathology from January 2015 to December 2017. Out of 212 cases most common thyroid lesion was Colloid goitre 35.38%(n=75) followed by Colloid goitre with cystic changes 19.81%(n=42), Follicular Neoplasm 19.34%(n=41), Hashimoto thyroiditis 7.55%(n=16), Colloid cyst 6.13%(n=13), Infected cystic lesion 2.83%(n=6), Benign hyperplasia of thyroid 2.36%(n=5), Adenomatoid goitre 1.89%(n=4), Thyroglossal cyst 1.89%(n=4), Granulomatous thyroiditis 1.41%(n=3), Papillary thyroid carcinoma 0.94%(n=2) and least common was Lymphoma of thyroid 0.47%(n=1). Conclusion: FNAC is almost an accurate technique in diagnosis of palpable and overt thyroid lesions. Thyroid lesions are more common in females than males. Colloid goitre is the commonest thyroid lesion.

Histopathological profile of ovarian tumors in a tertiary care center- a descriptive study

2021 ◽  
Vol 9 (4) ◽  
pp. 1010
Author(s):  
Anitha Pallikkara V. ◽  
Shameem K. Ummer Ali
Keyword(s):  
Germ Cell ◽  
Malignant Tumors ◽  
Care Center ◽  
Tertiary Care ◽  
Age Groups ◽  
Germ Cell Tumors ◽  
Ovarian Tumors ◽  
Benign Tumors ◽  
Medical College ◽  
Epithelial Tumors

Background: Ovarian neoplasms are a heterogeneous group of tumors with varied clinical, morphological and histological features. Ovarian cancer accounts for about 3% of all cancer in females and is the 5th most common cause of death due to cancer because most ovarian tumors spread beyond ovary by the time of diagnosis. The objective of the study was to document the histological pattern and prevalence of ovarian tumors in specimens received at department of pathology government medical college Alappuzha.Methods: This was a prospective study of 18 months duration which comprised of 245 cases of ovariectomy and ovariotomy specimens received in the department of pathology, govt. T.D medical college Alappuzha, Kerala. After detailed and thorough gross examination of the specimens, bits from representative areas were routinely processed and stained with H and E. Tumors were classified as per WHO classification. Appropriate immunohistochemical studies were performed wherever required.Results: Out of 245 cases studied, majority were benign tumors (78.36%), followed by malignant tumors (15. 11%). Borderline tumors comprised (6.53%) of the total cases. Age groups studied ranged from 11-70 years. Epithelial tumors were the most common (76.32%) followed by germ cell tumors (17.55%), sex cord stromal tumors (5.03%) and carcinoma arising in germ cell tumors (0.81%). Serous cystadenoma was found to be the commonest benign tumor and serous cystadenocarcinoma was the commonest malignant ovarian neoplasm.Conclusions: Surface epithelial tumors were the most common ovarian tumors. The maximum number of tumors were noted in the age group 21-40 years. Malignant tumors were common above 40 years. 

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