scholarly journals Correlation of Imprint and Crush cytology with Bronchoscopic biopsy in the diagnosis of Bronchogenic carcinoma

2021 ◽  
Vol 5 (1) ◽  
pp. 60-66
Author(s):  
Pratikchya Karki ◽  
Samir Neupane ◽  
Ashesh Dhungana ◽  
Sumida Tiwari
Keyword(s):  
Histopathological Examination ◽  
Diagnostic Yield ◽  
Cost Effective ◽  
Pulmonary Medicine ◽  
Male Predominance ◽  
Additional Information ◽  
Resource Setting ◽  
Common Location ◽  
Sensitivity Specificity ◽  
A Prospective Study

Introduction: Lung carcinoma is the most common cancer with 2.1 million (11.6%) newly diagnosed cases in 2018. Over the years, many cytotechniques have been developed but their combination with histology is still an area of controversy. Imprint and crush cytology are considered simple, rapid and cost effective for a low resource setting in the early diagnosis and management of lung cancer. Here, we aimed to assess the diagnostic accuracy of imprint and crush cytology and compare them with histopathology.  Method: A prospective study was conducted from May 2017 to April 2018 at the Pulmonary medicine unit and Department of Pathology at National Academy of Medical Sciences (NAMS), Bir Hospital. A total of 53 patients were enrolled in the study who showed visible mass on bronchoscopy. Three to five bits of tissue were obtained, imprint and crush smear were prepared from them and the tissue were then sent for histopathological examination. The level of significance selected was p < 0.005.  Results: The most common age group affected was 60-69 years. 91% cases were smokers, with a male predominance. The most common location of endobronchial growth was left upper lobe. 43 cases were malignant in biopsy. The sensitivity, specificity, accuracy and positive predictive value of imprint cytology was 71.05%, 87.50%, 73.91% and 96.43% respectively while that for crush cytology was 74.36%, 75%, 74.47% and 93.55% respectively. The diagnostic yield of imprint, crush smear and forceps biopsy were 52.8%, 58.4% and 81.1% respectively. Squamous cell carcinoma was the most common carcinoma in this study.  Conclusion: Imprint and crush cytology yield additional information that can be complementary to endobronchial biopsy. They are convenient, do not burden the patients and thus can be carried out wherever possible during bronchoscopy. 

scholarly journals Diagnostic Yield of Medical Thoracoscopy in Undiagnosed Exudative Pleural Effusion- A Tertiary Centre Experience from Aligarh Muslim University, Uttar Pradesh, India

2020 ◽  
Author(s):  
Mohammad Arif ◽  
Rakesh Bhargava ◽  
Mohammad Shameem ◽  
Nafees Ahmad Khan ◽  
Sadaf Sultana
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Histopathological Examination ◽  
Diagnostic Yield ◽  
Uttar Pradesh ◽  
P Value ◽  
Fisher Exact Test ◽  
Pulmonary Medicine ◽  
Medical Thoracoscopy ◽  
Exudative Pleural Effusion

Introduction: Pleural effusions are one of the most common entities encountered by pulmonologists worldwide which have a very long list of causes. Initial workup of these patients begins with a chest X-ray and percutaneous or Ultrasound (USG) guided thoracocentesis followed by biochemical and cytological evaluation of the fluid to ascertain the cause of effusion. A 20 to 25% of cases remain undiagnosed even after thoracocentesis and closed pleural biopsy. Medical Thoracoscopy is emerging as a safe diagnostic procedure in these patients. Aim: To detect the diagnostic yield of medical thoracoscopy in cases of undiagnosed exudative lymphocytic pleural effusion and to study the complications associated with it. Materials and Methods: This was a prospective observational study, carried out in the Department of Pulmonary Medicine, JN Medical College and hospital, Aligarh Muslim University (AMU), Aligarh, Uttar Pradesh, India, from August 2016 to August 2018. Undiagnosed exudative pleural effusion was defined as pleural effusion with Adenosine Deaminase (ADA) levels less than 70 IU/L and negative pleural fluid cytology for malignancy. Thoracoscopic examination of the pleural space using flexi-rigid thoracoscopy was done and biopsy was taken from suspected areas and the tissue obtained, was send for histopathological examination. The results were presented as mean±SD (Standard Deviation) or percentage. Differences in categorical data were compared using the chi-square test or the Fisher-exact test. A p-value of <0.05 was considered statistically significant. Results: Fifty patients underwent thoracoscopy for undiagnosed pleural effusion. Most common gross thoracoscopy finding was nodules which was seen in 23 patients. Malignancy was the most common histopathological finding, seen in 22 patients. Minor complications were seen in five patients. A final diagnosis could be made in 41 patients; the diagnostic yield was 82%. Conclusion: Medical thoracoscopy should be performed in all patients in which radiological and pleural fluid examinations could not lead to a definitive diagnosis as it has high sensitivity and a very low rate of complications.

scholarly journals Diagnostic yield of transbronchial needle aspiration for lymphoma

2016 ◽  
Vol 22 (3) ◽  
pp. 67
Author(s):  
B Sonnekus ◽  
J Steenkamp ◽  
M Louw ◽  
C F N Koegelenberg
Keyword(s):  
Predictive Value ◽  
Diagnostic Yield ◽  
Cost Effective ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
Tracheobronchial Tree ◽  
Transbronchial Needle Aspiration ◽  
Predictive Values ◽  
Hilar Adenopathy ◽  
Sensitivity Specificity

<p>Background. Transbronchial needle aspiration (TBNA) is a minimally invasive bronchoscopic technique that is cost-effective and safe for diagnosing mediastinal and hilar adenopathy in lung cancer, other malignancies, sarcoidosis and infectious processes such as tuberculosis. Few studies have analysed the sensitivity, specificity and predictive values of TBNA for diagnosing lymphoma.</p><p>Objective. To evaluate the diagnostic yield of TBNA for diagnosing mediastinal and hilar adenopathy in suspected lymphoma.</p><p>Methods. We performed a retrospective analysis of collected data of patients with mediastinal and hilar adenopathy adjacent to the tracheobronchial tree detected by thoracic computed tomography, who underwent TBNA at Tygerberg Hospital between July 2010 and June 2013. We included 25 patients with suspected or proven lymphoma. Histology was used as the gold standard.</p><p>Results. Adequate samples for cytological evaluation were obtained for 22 (88%) patients. Cytological diagnosis was possible for 8 (32%). For 17 (68%) who could not be diagnosed by TBNA alone, histology provided final diagnosis. Rapid on-site examination (ROSE) was performed in 23 (92%). In 17/23 (74%) cases, these had similar results to formal cytology. Only 4 (16%) had flow cytometry requested. Twelve (48%) had lymphoma confirmed on histology. TBNA cytology had 100% specificity and positive predictive value for suspicion of lymphoma. Sensitivity was 33% and negative predictive value 62%.</p><p>Conclusion. TBNA is an appropriate first-line diagnostic procedure in evaluating mediastinal and hilar lymphadenopathy in suspected lymphoma. Biopsy should be the immediate second-line procedure when ROSE/cytology is suspicious of lymphoma or shows atypical cells. Patients with negative TBNA cytology, but high clinical or radiological suspicion of lymphoma, should be further investigated.</p>

Utility of High-Resolution Sonography for Evaluation of Knee Joint Pathologies as a Screening Tool

2021 ◽  
pp. 875647932110357
Author(s):  
Atul Pratap Singh ◽  
Shruti Chandak ◽  
Arjit Agarwal ◽  
Ankur Malhotra ◽  
Ashwani Jain ◽  
...  
Keyword(s):  
High Resolution ◽  
Knee Joint ◽  
Predictive Value ◽  
Screening Tool ◽  
Diagnostic Yield ◽  
Cost Effective ◽  
Joint Effusion ◽  
Symptomatic Knee ◽  
Good Diagnostic Accuracy ◽  
Sensitivity Specificity

Objective: Magnetic resonance imaging (MRI) has been established as the gold standard imaging technique for assessing knee joint pathologies. However, high-resolution sonography (HRS) is affordable, easily available, cost-effective, and can be used for knee joint assessment. This study was conducted to assess the diagnostic yield of HRS in the evaluation of knee joint pathologies compared with MRI. Materials and Methods: In the study, 103 patients, with symptomatic knee pain, were included. HRS was performed followed by MRI. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated. Kappa values were calculated to assess the performance of HRS compared with MRI. Results: The most frequent pathologies observed on HRS were knee joint effusion (84%) followed by medial meniscal (43%) and lateral meniscal (26%) tear. Conclusion: HRS demonstrated good diagnostic accuracy in diagnosis of knee joint pathologies as compared with MRI. Therefore, HRS could be utilized as a screening tool for detection of knee joint pathologies.

scholarly journals General practitioner screening for melanoma: sensitivity, specificity, and effect of training

1998 ◽  
Vol 5 (3) ◽  
pp. 156-161 ◽  
Author(s):  
R C Burton ◽  
C Howe ◽  
L Adamson ◽  
A L Reid ◽  
P Hersey ◽  
...  
Keyword(s):  
Skin Cancer ◽  
Histopathological Examination ◽  
Cost Effective ◽  
Predictive Values ◽  
Men And Women ◽  
Pigmented Lesions ◽  
Melanoma Diagnosis ◽  
Cancer Specialists ◽  
Sensitivity Specificity ◽  
The Cost

Objective To measure the performance of trained and untrained general practitioners (GPs) in screening men and women aged 50 or more for melanomas. Methods GPs trained in melanoma diagnosis, untrained GPs, and skin cancer specialists examined groups of volunteers, each of which included a small number of subjects with prediagnosed suspicious pigmented lesions (SPLs) that were subsequently excised for histopathological examination. Results Trained and untrained GPs achieved mean sensitivities of 0.73 and 0.71, and mean predictive values of 0.40 and 0.37, respectively, for the detection of prediagnosed SPLs. When the SPLs had been excised and examined histopathologically, reanalysis showed mean sensitivities of 0.98 and 0.95, mean specificities of 0.52 and 0.49, and mean positive predictive values of 0.24 and 0.22 for the detection of subjects with melanomas by trained and untrained GPs respectively. Trained GPs were significantly better than untrained GPs at diagnosing as melanomas SPLs that subsequently proved to be melanomas (p=0.04). Conclusions GPs in this study achieved high sensitivities in screening older Australian men and women for melanomas, but at the cost of low specificities and positive predictive values. Training in melanoma diagnosis had no significant effect on sensitivity, specificity, and positive predictive value for screening. Data from the study were tested in a model of population screening for melanomas, and costs per life year saved for men aged 50–70 ranged from &dollar;A11 852 to &dollar;A40 259 depending upon the screening interval and whether the GPs excised the SPLs diagnosed, or referred all patients to skin cancer specialists; this would be as cost effective as cervical cancer screening.

scholarly journals Clinico-Haematological Study of Pancytopenia

2021 ◽  
Vol 33 (1) ◽  
pp. 12-18
Author(s):  
Samira Taufique Reshma ◽  
Susane Giti ◽  
Shahed Ahmed Chowdhury ◽  
Mohammad Golam Rabbani ◽  
Mohammad Iqbal Kabir ◽  
...  
Keyword(s):  
Diagnostic Yield ◽  
Bone Marrow Aspiration ◽  
Armed Forces ◽  
Clinical Findings ◽  
Diagnostic Challenge ◽  
Male Predominance ◽  
Life Saving ◽  
Medicine Today ◽  
A Prospective Study ◽  
Physical Findings

Introduction: Pancytopenia is a clinical condition, which refers to a combination of anaemia, leucopenia and thrombocytopenia. It often poses diagnostic challenge to physician and the knowledge of accurate etiologies of this condition is crucial in the management of the patient. Materials and Methods: The study was a prospective study done over a period of October 2011 to December 2011 and 50 patients were evaluated clinically along with haematological parameters, bone marrow aspiration and wherever required, a trephine biopsy was performed in Haematology department of Armed forces institute of pathology (AFIP), Dhaka cantonment, Dhaka. In all patients, a detailed relevant history along with a physical examination was done and data was collected using pre designed proforma. Results: Among the 50 cases studied, age of the patients ranged from 3 to 80 yrs with a mean age of 37.5 yrs and male predominance. Fever and generalized weakness were the most common symptoms. The commonest physical findings were pallor followed by splenomegaly and hepatomegaly. Anisopoikilocytosis and relative lymphocytosis was the most prominent peripheral blood findings in patients. The commonest cause of pancytopenia was Aplastic anaemia (36%), followed by Myelodysplastic syndrome (18%), visceral leishmaniasis (12%), Megaloblastic anaemia (8%), Acute leukaemia (6%), Myelofibrosis (4%), Multiple myeloma (4%), Hypersplenism (4%), Malaria (2%). Conclusion: As a large number of pancytopenic patients have a reversible aetiology, early & proper diagnosis may be life saving. Maximum diagnostic yield can be achieved by correlation with clinical findings & laboratory parameters. Medicine Today 2021 Vol.33(1): 12-18

scholarly journals Smear technique for intraoperative diagnosis of central nervous system neoplasms

2014 ◽  
Vol 4 (7) ◽  
pp. 544-547
Author(s):  
S Shrestha ◽  
BK Thapa ◽  
B Bhattarai
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Histopathological Examination ◽  
Frozen Section ◽  
Cost Effective ◽  
Metastatic Tumor ◽  
Rapid Diagnosis ◽  
Central Nervous System Neoplasms ◽  
A Prospective Study ◽  
Nervous System Neoplasms

Background: Smear cytology has become increasily popular as an alternative to frozen section for the rapid diagnosis of most of central nervous system lesions. The aim of this study was to assess the utility of smear technique for the rapid diagnosis in the neurosurgical biopsies and to compare the smear cytological features with the final histopathological examination. Materials and Methods: This was a prospective study conducted in the Department of Pathology of BP Koirala Memorial cancer Hospital for a period of one year. Sixty cases of clinically suspected CNS tumors were sent for intraoperative smear cytological examination and histological examination. Both techniques were then compared for their ability to diagnose as well as grade the tumors. Results: Gliomas (51.6%) were the most frequently occurring tumors in the total cases. Diagnostic accuracy of squash/smear technique achieved was 88 %( 53/60) when compared with histopathological diagnoses. In two cases, smears comprised of blood clots and no opinion was possible in cytology. Complete discrepancy was seen in five cases that included two cases of atypical meningioma, a one case each of germinoma, glioblastoma and metastatic tumor. Conclusion: Smear technique is a fairly accurate, rapid, easily reproducible and cost effective tool to diagnose brain tumours. Smear cytology is of great value in Intraoperative consultation of central nervous system lesions. DOI: http://dx.doi.org/10.3126/jpn.v4i7.10296 Journal of Pathology of Nepal (2014) Vol. 4, 544-547 

scholarly journals Importance of Routine Histopathological Examination of Gallbladder Specimen in Detecting Incidental Malignancies

2016 ◽  
Vol 4 (1) ◽  
pp. 15
Author(s):  
Archana Tiwari ◽  
Ramji Rai ◽  
Surendra Kumar Jain
Keyword(s):  
Gall Bladder ◽  
Gallbladder Carcinoma ◽  
Histopathological Examination ◽  
College Teaching ◽  
Biliary Tree ◽  
Epidemiological Studies ◽  
Medical College ◽  
Common Location ◽  
Incidental Gallbladder Cancer ◽  
A Prospective Study

Introduction: Gallbladder carcinoma is the most common cancer of biliary tree and the 5th most common gastrointestinal malignancy.  An early diagnosis is essential as this malignancy progresses silently with a late diagnosis and poor prognosis. Epidemiological studies have identified striking geographic and ethnic variation with high occurrence in Southeast Asia, yet low elsewhere in the world. Gallbladder carcinoma, in 15-30% of patients, show  no preoperative  or intraoperative evidence and are detected only on histopathological examination. They are called as incidental gallbladder cancer (IGBC). The objective of this study was to find out the occurrence of IGBC in cholecystectomy specimens received in our histopathology laboratory and to analyze their clinico-pathological features.   Methods: This was a prospective study carried out in the Department of Histopathology, Lumbini Medical College Teaching Hospital during a period of two years from May 2014 to April 2016. The study included 800 cases of cholecystectomized Gall bladder specimens.   Result: Ninety seven percent of the specimens (n=776) revealed benign pathology. Malignancy was detected incidentally in 8 cases (1.25%). The mean age of patients with incidental Gall bladder carcinoma was 69 years (SD=4.1) and F:M ratio was 9:1. Out of 10 incidental malignancies, cholelithiesis was found in 8 (80%) cases. Fundus was the most common location (n=5, 50%) and focal fragile necrotic area was most common (n=3, 30%) gross morphology. On pathological staging, all the incidentally detected malignancies (n=10) were found to be in surgically resectable stages.   Conclusion: IGBC was found in 1.25% of the gallbladder specimen. Detailed gross and histopathological examination of gallbladder specimen is mandatory for every cholecystectomy specimen, even for benign diseases, to detect incidental carcinoma at potentially curable stage.

scholarly journals Cyto-histological correlation in diagnosis of gastrointestinal lesions- a prospective study in a tertiary care institute

2020 ◽  
Vol 8 (10) ◽  
pp. 3560
Author(s):  
Swati Aggarwal ◽  
Kavita Mardi ◽  
Shivani Sood ◽  
Vijay Kaushal ◽  
Brij Sharma ◽  
...  
Keyword(s):  
Diagnostic Yield ◽  
Tertiary Care ◽  
Cost Effective ◽  
Brush Cytology ◽  
Non Invasive ◽  
Care Institute ◽  
Cost Effective Method ◽  
Gastrointestinal Lesions ◽  
Rising Incidence ◽  
A Prospective Study

Background: Gastrointestinal tract is involved by a large number of inflammatory, infectious and neoplastic diseases. There is a worldwide rising incidence of GIT lesions especially neoplasms.Methods: This study was planned to correlate endoscopic and colonoscopic brush cytology with histopathology of gastrointestinal lesions and to determine the spectrum of gastrointestinal lesions in patients subjected to endoscopic brushings and biopsy.Results: Sensitivity of upper GI brush cytology was 95.15% and specificity 90.41%. Sensitivity of colonoscopic brush cytology was 100% and specificity 86.79%. The accuracy of brush cytology came out to be 92.45% in upper GIT and 92.22% in lower GIT.Conclusions: Brush cytology is a non-invasive and cost-effective method to retrieve epithelial cells from a much larger surface area of the mucosa, thus allowing thorough sampling and increasing the diagnostic yield.

scholarly journals Prospective study on usefulness of sural-nerve biopsy

2021 ◽  
Vol 9 (10) ◽  
pp. 3095
Author(s):  
Nipun Saproo ◽  
Roma Singh
Keyword(s):  
Prospective Study ◽  
Sural Nerve ◽  
Diagnostic Yield ◽  
Cost Effective ◽  
Nerve Biopsy ◽  
Neurological Complications ◽  
Sural Nerve Biopsy ◽  
Duration Of Illness ◽  
Effective Diagnosis ◽  
A Prospective Study

Background: Peripheral neuropathies are a heterogeneous group of disorders, but common among patients attending neurology clinics. A systematic approach, like sural nerve biopsy, is the need of the hour, for a cost effective diagnosis. Studies have shown that nerve biopsy improves treatment in up-to 60% patients. Present study was conducted to evaluate the clinical profile and usefulness of sural nerve biopsy in peripheral neuropathy.Methods: A prospective study was conducted in the Department of Neurology in collaboration with Department of Pathology, Medanta: The Medicity, Gurugram, for a period of six months from January 2019- June 2019. Out of total 82 randomly selected patients, 43 patients were selected for nerve biopsy.Results: Mean age in the biopsy group was 45.61±19.24 years. Duration of illness was less than 1 year in 60.5% patients. In 39.5% of cases, nerve biopsies established the diagnosis and in total 77% of cases it was worthwhile.  Hansen’s disease was diagnosed in 44%, CIDP in 12%, Vasculitis in 14%, and diabetes in 7% patients. Biopsy proved more diagnostic when tingling and numbness was there. Diminished DTRs was also statistically significant symptom in biopsy favoring group. Nerve biopsy in multiple mononeuropathy (65.1%) proved more beneficial than in polyneuropathy (32.6%). Similarly, motor-sensory was a predominant presentation in 28 (65.1%) patients with nerve biopsy being more valuable.Conclusions: Nerve biopsy, having a good diagnostic yield, can be a useful aid in cases with multiple mono-neuropathy. It can be the key to prevent long term neurological complications in patients. 

Evaluation of Breast Lumps by Ultrasound and Correlation with Histological Findings

2020 ◽  
Vol 23 (1) ◽  
pp. 10-12
Author(s):  
Nelema Jahan ◽  
Md. Mamunur Rahman ◽  
Mohammad Shahidul Alam ◽  
Md Saiful Islam
Keyword(s):  
Histopathological Examination ◽  
Breast Diseases ◽  
Histopathological Study ◽  
Common Symptom ◽  
Breast Lump ◽  
Histopathological Findings ◽  
Malignant Breast ◽  
Breast Lumps ◽  
One Year ◽  
A Prospective Study

Background: A breast lump is the most common symptom associated with both benign and malignant breast diseases. Therefore, a distinction of benign from malignant lump is of importance for proper management. Though a definitive diagnosis is possible with imaging for all the lesions, histopathological study is proven essential for confirming the diagnosis. Objective: The objective of this study was to evaluate the role of USG and histopathological findings of different breast lump in diagnosis and their comparison. Methods: A prospective study was conducted over a period of one year from January 2017 to December 2017. A total of 116 patients were included in this study. All breast lumps underwent surgery and the ultrasound findings of these lumps were compared with the histopathological findings. Data were collected from these patients by a preformed questionnaire and finally the data were analyzed. Results: Out of 116 patients only 21 cases were reported as malignant in ultrasound report but histopathology revealed 31 malignant patients. On histopathological examination 10 benign cases turned out to be malignant. Conclusion: The present study was undertaken to evaluate in diagnosing breast mass lesions individually by ultrasound and compared with histopathology for definitive management of a patient. Journal of Surgical Sciences (2019) Vol. 23 (1) : 10-12

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