scholarly journals Histopathological Examination in the Categorization of fungal Rhinosinusitis - a Retrospective Study

2021 ◽  
Vol 4 (2) ◽  
pp. 478-481
Author(s):  
Sangeetha Kandasamy ◽  
Megala Chandrasekar ◽  
Thamilselvi Ramachadran
Keyword(s):  
Clinical Diagnosis ◽  
Gold Standard ◽  
Nasal Polyps ◽  
Histopathological Examination ◽  
Clinical Suspicion ◽  
Fungal Sinusitis ◽  
Medical College ◽  
Fungal Rhinosinusitis ◽  
Hematoxylin And Eosin ◽  
Made In

Introduction: Fungal Rhinosinusitis is broadly defined as any sinonasal pathology related to the presence of fungi and is increasingly recognized worldwide. This study aimed to assess and ascertain the need for histopathological examination in the management of fungal Rhinosinusitis. Materials and Methods:  This study was performed over two years, from April 2019 to April 2021, in the Department of Pathology, Vinayaka Missions KirupanandaVariyar Medical College and Hospital, Salem. A total of 383 cases of rhinosinusitis/nasal polyps were studied. Histopathological examination and categorization were done and compared with clinical diagnosis. Results: Only 4/18 cases of acute fungal Rhinosinusitis were correctly diagnosed(22.22%). Nineteen cases of the fungal ball were diagnosed, but none was correctly categorized. Clinical suspicion of fungal sinusitis was present in 10 cases of Rhinosinusitis, which turned out to be chronic Rhinosinusitis in histopathology. In AFRS, fungal elements were overlooked in Hematoxylin and Eosin stained slides and identified only by Grocottmethenamine silver in one-fourth of the cases. Conclusions: Though clinical diagnosis was made in 86% of fungal rhinosinusitis cases, correct categorization was done only in one-third of cases. CT scan could diagnose 60% of cases, but none was categorized. As treatment depends on the type of fungal Rhinosinusitis, histopathological examination is the gold standard for diagnosing and treating fungal Rhinosinusitis.

scholarly journals Routine histopathological examination of the foreskin after circumcision for clinically suspected lichen sclerosus in children: Is it a waste of resources?

2018 ◽  
Vol 12 (5) ◽  
pp. E231-3 ◽  
Author(s):  
Fahad A. Alyami ◽  
Zhoobin Heidari Bateni ◽  
Raken Odeh ◽  
Walid A. Farhat ◽  
Martin Koyle
Keyword(s):  
Clinical Diagnosis ◽  
Histopathological Examination ◽  
Lichen Sclerosus ◽  
Retrospective Chart Review ◽  
Clinical Suspicion ◽  
Pathological Diagnosis ◽  
Balanitis Xerotica Obliterans ◽  
Presenting Symptoms ◽  
Review Period ◽  
The Mean

Introduction: Circumcision is one of the most widely performed procedures in the world. One of the indications for circumcision is lichen sclerosis (LS). The natural history of LS in children is not as well-documented as in adult patients. Surgeons use the appearance of the foreskin or meatus to predict the diagnosis of LS.1 Indeed, if the diagnosis of LS is made in childhood, does it change management in the long-term? Pathological analysis of the excised foreskin is routinely done if there is suspicion of LS. Our aim is to assess the concordance between the clinical and pathological diagnosis of suspected LS and to assess the need for sending the foreskin for pathological examination.Methods: We conducted a retrospective chart review of 64 of 420 boys who underwent circumcision in a tertiary children’s hospital from June 2005 to June 2014, and who had their foreskin sent for pathology due to the clinical suspicion of LS. Demographics, presenting symptoms, presumed clinical diagnosis, pathological findings, and followup data were collected and analyzed. Results: Over the review period, 64 patients underwent circumcision for presumed LS. The mean age of the children was 9.7 years (range 3‒16.5). All the children who had circumcision for presumed LS diagnosis were symptomatic. LS was confirmed in 47 of 64 foreskins (73.5%). Balanitis xerotica obliterans (BXO) was clinically suspected in 40 (85%) of the 47 patients. The mean followup was 10 months (range 1–15), with seven recurrences (15%) during that period. The recurrences required revision surgery in two patients and five were managed with steroids only. Conclusions: In our series, the clinical diagnosis correlated with the pathological diagnosis in most cases. A clinical suspicion of LS without routine foreskin pathological assessment will reduces the overall cost to the healthcare system. Appropriate counselling of the patient/parents and their primary caregiver is imperative, as recurrence is common.

scholarly journals Nasal Polyposis and Fungal Schizophyllum Commune Infection: A Case Report

2011 ◽  
Vol 54 (2) ◽  
pp. 83-86 ◽  
Author(s):  
Aleksandar Perić ◽  
Danilo Vojvodić ◽  
Lidija Zolotarevski ◽  
Aneta Perić
Keyword(s):  
Rare Case ◽  
Nasal Polyps ◽  
Nasal Polyposis ◽  
Histopathological Examination ◽  
Schizophyllum Commune ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis ◽  
Fungal Hyphae ◽  
Oral Itraconazole ◽  
Basidiomycete Fungus

We present a rare case of eosinophilic fungal rhinosinusitis with nasal polyps in a 32-year-old woman caused by basidiomycete fungusSchizophyllum commune. Diagnosis was done by the endoscopic nasal examination, computed tomography (CT) of the paranasal sinuses, the histopathological examination of polyps, the presence of eosinophils and fungal hyphae in nasal mucus and by the detection ofS. communeby culture. The patient was successfully treated by combination of oral itraconazole and topical corticosteroid therapy combined with surgery. The pathogenesis and diagnosis of allergic fungal rhinosinusitis are also discussed.

scholarly journals Study to Determine the Incidence of Allergic Fungal Sinusitis among Patients with Nasal Polyps and Its Related Risk Factors

2021 ◽  
Vol 15 (7) ◽  
pp. 1860-1863
Author(s):  
Bakht Zada ◽  
Ejaz Ahmed ◽  
Muhammad Habib ◽  
Zafar Iqbal ◽  
Rehan Saleem ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nasal Septum ◽  
Nasal Polyps ◽  
Bone Erosion ◽  
Histopathological Examination ◽  
Sinus Surgery ◽  
Fungal Sinusitis ◽  
Deviated Nasal Septum ◽  
Allergic Fungal Sinusitis ◽  
Turbinate Hypertrophy

Aim: To govern the incidence of allergic fungal sinusitis in patients with nasal polyposis. Various anatomical risk factors were also investigated, including turbinate hypertrophy, deviated nasal septum and comorbidities such as asthma and diabetes. Study Design: This is a Descriptive cross-sectional study. Place and duration of study:The study was conducted at ENT Head &Neck Surgery department, Lady Reading Hospital MTI, Peshawar and Azra Nahid Medical College, Lahore for the duration of six months from May 2020 to October 2020. Methods: 110 patients with nasal polyps were evaluated and operated on. Samples were sent for histopathological examination and culture. All patients were assessed with clinical examination and detailed history. Laboratory tests were performed including complete blood counts, urea, electrolytes, ECG and chest radiographs for the suitability of general anesthesia as a prerequisite for surgery. In 95% of cases, computed tomography was recommended to check for sinus involvement, bone erosion, osteo-hypertrophic complex, turbinate hypertrophy, nasal septal deviation, and intracranial and intra-orbital enlargement. MRI examinations were also recommended in cases of suspected intraocular and intracranial disease (5%). Data was scrutinized on a computer using SPSS version 22.0. Results:Of the 110 patients, 65 were male and 45 were female, with a mean age of 1and ranged from 7 to 80 years. All patients had nasal polyps. The incidence of AFS was approximately 29.1% and the remaining 78 had a different pathology. Major deviation of the nasal septum and bilateral hypertrophy of the inferior turbinate’s were observed in 6 (18.7%) and 4 (12.5%) patients, respectively. Unilateral nasal polyps were observed in 7 (21.9%) patients and bilateral nasal polyps in 18 (52.3%). 19/32 (59.4%) of the cases underwent functional endoscopic surgery of the paranasal sinuses, and in 6 (18.7%) external fronto-ethmoidectomy. Two patients underwent nasal ethmoidectomy. Septoplasty and endoscopic sinus surgery were performed in a total of 3 (9.37%) cases. Key words:Allergic bronchopulmonary aspergillosis (ABPA), Allergic fungal sinusitis (AFS).

scholarly journals Benign Sinonasal Masses: A Clinicopathological and Radiological Profile

2014 ◽  
Vol 11 (1) ◽  
pp. 4-8 ◽  
Author(s):  
A Nepal ◽  
ST Chettri ◽  
RR Joshi ◽  
S Karki
Keyword(s):  
Paranasal Sinus ◽  
Nasal Polyps ◽  
Histopathological Examination ◽  
Treatment Plan ◽  
Final Diagnosis ◽  
Benign Tumors ◽  
Ossifying Fibroma ◽  
Fungal Sinusitis ◽  
Imaging Studies ◽  
Inverted Papillomas

Background Benign nasal and paranasal sinus masses are commonly encountered in clinical practice. Though benign, certain nasal polyps, fungal sinusitis, hemangiomas and fibro-osseous tumors can present with locally destructive features and deformities, mimicking malignancies at once. Objective This study was carried out to recognize the great variety of benign nasal lesions and their frequency in our region. Methods A retrospective chart analysis of cases presenting as mass in nose and paranasal sinus that underwent surgery over three years duration at our institute was done. A provisional diagnosis was made after clinical assessment and radiological investigations, but the final diagnosis was established after histopathological examination. Results A total 331 cases presented as masses in nose and paranasal sinus presented during the period. The clinicopathological examination aided by endoscopic and imaging studies revealed the non neoplastic benign masses in 293 and neoplastic masses in 38. Polyps were the commonest lesions constituting 70% cases followed by rhinosporidiosis in 10%. Fungal sinusitis, squamous papillomas, hemangiomas and inverted papillomas were found to be in order of 4.5%, 4%, 3.5% and 3% respectively. Rare cases like “rhino-oto-cereberal” form of mucormycosis, angiomyoma, and psammomatoid ossifying fibroma were also observed in the study. Conclusion Most of the nasal polyps/fungal sinusitis can be diagnosed clinically. However many a times Computer tomography (CT) scan and biopsy are necessary to differentiate them from each other and treatment plan. Certain benign tumors have high potential for malignant transformation while others can present with locally destructive features and deformities. DOI: http://dx.doi.org/10.3126/kumj.v11i1.11015 Kathmandu University Medical Journal Vol.11(1) 2013: 4-8

scholarly journals HYSTERECTOMIES

2011 ◽  
Vol 18 (01) ◽  
pp. 46-50
Author(s):  
QAMAR-UR- NISA ◽  
HABIB ULLAH ◽  
TANWEER AHMED SHAIKH ◽  
Miss Hemlata ◽  
Fatima Memon ◽  
...  
Keyword(s):  
Coming Out ◽  
Histopathological Examination ◽  
Medical College Hospital ◽  
Uterovaginal Prolapse ◽  
Histopathological Diagnosis ◽  
College Hospital ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Chronic Cervicitis ◽  
Made In

Objective: To audit indications and histopathological diagnosis of hysterectomies performed at Muhammad Medical College hospital, Mirpurkhas. Study Design: Retrospective study. Place and Duration of Study: Department of Obstetrics and Gynaecology and Department of Pathology, Muhammad Medical College Hospital, Mirpurkhas Sindh from January to December 2008. Methodology: Data regarding symptoms and indications of hysterectomies performed during this year were collected from files and patient records. Histopathological reports of those patients were collected from department of pathology. The results were analyzed by percentages. Results: A total of 145 hysterectomies were performed in 2008. Mean age of patients was 45years ranging from 35-60 years and parity ranges from 4 – 10. Most common presenting complaints were excessive menstrual blood loss in 97(67%) patients, followed by some thing coming out of vagina 28(19%). Most common pre-operative diagnosis of fibroid was made in 44 (33%) followed by uterovaginal prolapse in 28(19%) and dysfunctional uterine bleeding (DUB) in 18(12%) of patients. Regarding histopathological diagnosis chronic cervicitis was the most commonly diagnosed pathology in 45 (31%) followed by fibroid in 25(17%) cases. Conclusions: A yearly audit should be conducted in every institute to collect data and to analyze the pattern of indication and lesions found on histopathological examination. 

scholarly journals A Clinico-Histopathological Study of Orbital and Ocular Lesions; a Multicenter Study

2013 ◽  
Vol 3 (2) ◽  
pp. 40-44 ◽  
Author(s):  
P Bastola ◽  
S Koirala ◽  
G Pokhrel ◽  
P Ghimire ◽  
RK Adhikari
Keyword(s):  
Histopathological Examination ◽  
Correct Diagnosis ◽  
Age Groups ◽  
Histopathological Study ◽  
Cross Sectional ◽  
Medical College ◽  
Ocular Lesions ◽  
Granuloma Pyogenicum ◽  
Orbital Lesions ◽  
Made In

The study aimed at finding out the morphological and clinico-pathological correlation of Orbital and Ophthalmic lesions in various eye institutes of Nepal. The study also aimed at finding out the prevalence of Ophthalmic lesions needing histo­pathological examination. This cross sectional descriptive study was carried out in various tertiary eye hospitals of Nepal from 2008 – 2012. The department of pathology was also incorporated in giving the correct histopathological findings in time. All the relevant data were entered in a specifically designed proforma for the study and analyzed. One hundred Oph­thalmic and Orbital lesions were studied in various age groups. Ophthalmic and Orbital lesions were highest (18%) in 31-40 year age group patients. Eyelid (57%) was the most commonly involved site. Clinical diagnosis was consistent with histo­pathological diagnosis in more than 60% of the cases. Among eyelid lesions, incidence of dermoid cyst (21%) was highest. While in Conjunctival lesions, granuloma pyogenicum (22.5%) was highest followed by other lesions. A clinico-patho­logical diagnosis of malignant orbital tumors or ocular tumors was made in 30% of cases. While 70% cases of Ophthalmic or orbital lesions were benign in nature. All Ophthalmic lesions removed surgically should always (without exception) be subjected to histopathological examination to establish correct diagnosis for further management. However this study has shown that a good clinical examination and diagnosis before subjecting the patient for histopathological examination gives the patient and the treating surgeon a better outcome. DOI: http://dx.doi.org/10.3126/jcmc.v3i2.8442 Journal of Chitwan Medical College Vol.3(2) 2013 40-44

scholarly journals Ultrasonography in acute appendicitis

2017 ◽  
Vol 13 (1) ◽  
pp. 203-206
Author(s):  
V Natraj Prasad ◽  
Pramod Kumar Chhetri
Keyword(s):  
Emergency Department ◽  
Acute Appendicitis ◽  
Clinical Diagnosis ◽  
Cross Section ◽  
Wall Thickness ◽  
Gold Standard ◽  
Histopathological Examination ◽  
Clinical Impression ◽  
Clinical Settings ◽  
Outer Diameter

Background & Objectives: This study was undertaken to establish the Ultrasonographic (USG) findings in acute appendicitis and to establish the accuracy of USG in the diagnosis of acute appendicitis.Materials & Methods: One hundred patients who presented to the emergency department with a clinical diagnosis of acute appendicitis were subjected to USG. USG findings of those patients suggestive of acute appendicitis were noted. The decision to operate for appendicitis was made on the surgeon's final clinical impression after correlating with USG findings. Histopathological examination of the appendicectomy specimen was taken as the gold standard for the diagnosis of acute appendicitis.Results: USG diagnosis of acute appendicitis is based on a combination of sonographic features. The findings of an aperistaltic tubular structure arising from the caecum with a target appearance on cross section, outer diameter of  > 6 mm, mural wall thickness > 3 mm, and probe tenderness over the visualized appendix should prompt the diagnosis in the appropriate clinical settings. The visualization of appendicolith is associated with higher rate of perforation and the visualization of fluid with internal echoes in acute appendicitis could suggest abscess formation.Conclusion: USG is a very useful and essential modality in the diagnosis of acute appendicitis with a sensitivity of 93.93%, specificity of 100%, PPV of 100%, NPV of 89.47% and an overall accuracy of 96% in the diagnosis of acute appendicitis.

scholarly journals Spectrum of Malignant Skin Lesion in Patients attending Nepalgunj Medical College and Teaching Hospital

2017 ◽  
Vol 2 (2) ◽  
pp. 156-161
Author(s):  
Reena Rana ◽  
G P Ghimire ◽  
S Gupta ◽  
M Singh ◽  
KK Jha ◽  
...  
Keyword(s):  
Skin Lesion ◽  
Clinical Diagnosis ◽  
Teaching Hospital ◽  
Malignant Tumor ◽  
Histopathological Examination ◽  
Cross Sectional Study ◽  
Histopathological Diagnosis ◽  
Cross Sectional ◽  
Medical College ◽  
Histopathological Correlation

IntroductionClinical diagnosis of dermatological manifestation of neoplastic skin lesion can pose a diagnostic difficulty at times. Histopathological diagnosis is mandatory for accurate characterization of disease entity for proper and timely management of cases.ObjectiveThe aim of this study was to analyze malignant tumor of skin with respect to age, sex, clinical features and histopathological features and to evaluate the accuracy of clinical diagnosis with histopathological correlation.MethodologyThis is hospital based cross-sectional study conducted at Nepalgunj Medical College and Teaching Hospital, Kohalpur from February 2010 to January 2011. A total of 70 histopathological specimens of skin biopsies were studied and correlated with the clinical diagnosis. The data was entered into Microsoft  office excel and analyzed using statistical package for social sciences (SPSS 17.0).ResultsMalignant tumor of skin constituted 21.4% of total cases. In malignant tumor, most common sites were head and neck regions followed by lower limb with keratinocytic tumors being in the majority. Most of the specimens (65.7%) were obtained as excisional biopsies.  Seven cases diagnosed as benign lesions clinically, turned out to be malignant on histopathological examination. Out of 13 cases in which clinical diagnosis was of malignancy, only 8 turned out to be malignant, thus for malignant lesions, the clinical diagnosis had a sensitivity of 53.3%, specificity of 90.9% and a positive predictive value of 61.5%.ConclusionsSquamous cell carcinoma was the most common malignant tumor in this study and histopathological correlation significantly modifies the overall management in dermatological disorders where clinical diagnoses are equivocal.Birat Journal of Health SciencesVol.2/No.1/Issue 2/ Jan - April 2017, Page: 156-161

scholarly journals Role of serum bilirubin in predicting the severity of acute appendicitis

2019 ◽  
Vol 6 (12) ◽  
pp. 4415
Author(s):  
Sandeep Y. Chinnapur ◽  
Naveen Kumar S. ◽  
Hanumanthaiah K. S.
Keyword(s):  
Acute Appendicitis ◽  
Clinical Diagnosis ◽  
Total Bilirubin ◽  
Serum Bilirubin ◽  
Histopathological Examination ◽  
Serum Total Bilirubin ◽  
Medical College ◽  
Gangrenous Appendicitis ◽  
Routine Investigations

Background: The aim of the study was to establish the role of hyperbilirubinemia as a new diagnostic tool to predict gangrenous/perforated appendicitis.Methods: A prospective study carried for 9 months (March 2018 to November 2018) at Rajarajeswari Medical College and Hospital. All patients admitted with clinical diagnosis of acute appendicitis and posted for surgery were included in the study. Serum total bilirubin results will be compared with Rajarajeswari Medical College and Hospitals laboratory reference values. These cases will be operated and clinical diagnosis will be confirmed per-operatively and post-operatively by histopathological examination. Final histopathological examination will be considered as a gold standard for diagnosing and categorizing patients as having normal appendix, acute appendicitis and acute appendicitis with perforation and/or gangrene. Based on histopathological examination patients will be categorized as positive (acute appendicitis with perforation and/or gangrene) and negative (acute appendicitis without perforation or gangrene).Results: Sensitivity of serum bilirubin in case of perforated/gangrenous appendicitis was found to be 90%. Specificity of serum bilirubin was found in case of perforated/gangrenous appendicitis was found to be 90.47%. Positive predictive value and negative predicting value of serum bilirubin in perforated/gangrenous appendicitis was found to be 81.8% and 95% respectively with p value of 0.003.Conclusions:Serum total bilirubin is an easily available and cheap and can be estimated from the same blood sample withdrawn for routine investigations, if added to routine investigations, then diagnosis of complicated appendicitis can be made with fair degree of accuracy.  

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