scholarly journals Comparative Study of Neck Swelling by Clinical, Cytological and Histopathological Examination

2020 ◽  
Vol 26 (1) ◽  
pp. 24-30
Author(s):  
Mohammad Idrish Ali ◽  
Md Mahmudul Huq ◽  
Momenul Haque ◽  
Kamrul Hasan Tarafder

Objective: In this study 50 patients of neck swelling were studied to compare the findings with clinical diagnosis and histopathological report for its diagnostic compatibility. Methods: This cross sectional study was done in Department of Otolaryngology –Head & Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka from July 2015 to June 2017. Fine needle aspiration cytology, MRI, CT scan, and histopathological examination of postoperative specimen of neck swelling, analyzed data presented by various tables, graphs and figures. Results:In the present series 50 cases of neck swelling were studied. Out of these 50 cases 19 were male and 31 were female. The male, female ratio was 1:1.63. Age range was 4 – 60 years with maximum frequency in the 4th decade with the 3rd and 2nd in the following suit. Most of the patient were poor. Clinical, cytological and histopathological diagnosis were available in all the cases. The three sorts of diagnoses were compared with each other. Histopathologically 12 cases were tubercular lymphadenopathy. Metastatic carcinoma and lymphoma 5 cases for each. Twelve were nodular goiter, 5 were thyroid carcinoma. Rest were benign, congenital and nonspecific inflammatory conditions. Correct diagnosis were made by FNAC in 45 cases. In the rest 5 cases smear were unsatisfactory in 2 cases and gives inconclusive result, remaining 3 were follicular neoplasm and no definitive result were made which were subsequently diagnosed by histopathological examination as a follicular adenoma in 1 and follicular carcinoma in 2. Sensitivity of FNAC in the diagnosis of neck masses were found 91% for tuberculosis, 100% for metastatic carcinoma also for salivary gland tumour. In case of nodular goiter sensitivity was 92%. But it is only 60% sensitive in case of thyroid malignancy, as FNAC can not demarcate clearly between follicular adenoma and follicular cell carcinoma. But its accuracy in diagnosing papillary cell carcinoma of thyroid was 100%. Conclusion: Keeping the limitations in mind, FNAC can reduce substantially the need of open biopsy for histopathological examination. Last of all I wish to conclude the study with the popular saying of Stewart “Diagnosis by aspiration is as reliable as the combined intelligence of the clinician and pathologist makes it”. Bangladesh J Otorhinolaryngol; April 2020; 26(1): 24-30

2012 ◽  
Vol 18 (1) ◽  
pp. 23-29
Author(s):  
Md Mahmudul Huq ◽  
Mohammad Idrish Ali ◽  
SM Nazmul Huque ◽  
KM Nurul Alam ◽  
Md Abdus Sattar ◽  
...  

Objective: In this study 50 patients of neck swelling were studied to compare the findings with clinical diagnosis and histopathological report for its diagnostic reliability.Methods: This cross sectional study was done in ENT Department of Sher-E-Bangla Medical College Hospital, Barisal, Bangabandhu Sheikh Mujib Medical University and Dhaka Medical College Hospital, Dhaka from July 2006 to December 2006. Fine needle aspiration cytology, MRI, CT scan, and histopathological examination of postoperative specimen of neck swelling, analyzed data presented by various tables, graphs and figures.Results: In the present series 50 cases of neck swelling were studied. Out of these 50 cases 19 were male and 31 were female. The male, female ratio was 1:1.63. Age range was 4 – 60 years with maximum frequency in the 4th decade with the 3rd and 2nd in the following suit. Most of the patient was poor. Clinical, cytological and histopathological diagnosis was available in all the cases. The three sorts of diagnoses were compared with each other. Histopathologically 12 cases were tubercular lymphadenopathy, 12 cases were nodular goiter, 5 cases were Metastatic carcinoma, 5 were thyroid carcinoma and another 5 cases were lymphoma, Rest were benign, congenital and nonspecific inflammatory conditions. Correct diagnosis was made by FNAC in 45 cases. In the rest 5 cases smear were unsatisfactory in 2 cases and gives inconclusive result, remaining 3 were follicular neoplasmand no definitive result were made which were subsequently diagnosed by histopathological examination as a follicular adenoma in 1 and follicular carcinoma in 2. Sensitivity of FNAC in the diagnosis of neck masses were found 91% for tuberculosis, 100% for metastatic carcinoma and also for salivary gland tumour. In case of nodular goiter sensitivity was 92%. But it is only 60% sensitive in case of thyroid malignancy, as FNAC can not demarcate clearly between follicular adenoma and follicular cell carcinoma. But its accuracy in diagnosing papillary carcinoma of thyroid was 100%.Conclusion: FNAC can reduce substantially the need of open biopsy for histopathological examination. Accuracy of FNAC will be improved with relevant information provided by clinicians.DOI: http://dx.doi.org/10.3329/bjo.v18i1.10410  Bangladesh J Otorhinolaryngol 2012; 18(1): 23-29


2021 ◽  
Vol 17 (1) ◽  
pp. 1-9
Author(s):  
Binita Goyal ◽  
Suman Rai ◽  
Mamata Sedhain ◽  
Pratigya Subedi

Introduction Pigmented skin lesions refer to lesions that are brown, black or blue in color. These are not always melanocytic in origin. Keratinocytic, vascular or reactive pigmentation in other lesions can also appear pigmented. The main aim of the study was to see the histopathological spectrum and objective was to compare clinical and histopathological diagnoses in pigmented skin lesions. Methods This descriptive study was carried out on 43 pigmented skin lesions that were biopsied over a 1 and half year period from Jan 2018 to June 2019 in College of Medical Sciences and Teaching Hospital. Results Age of the patient ranged from 10 to 88 years and mean±SD was 42.02±19.73 years. There were 21 (48.8%) males and 22 (51.2%) females with a male female ratio 0.9:1. Melanocytic nevus was the most common histopathological diagnosis (11 cases, 25.6%). Reactive pigmentation was seen in 20 (46.5%) cases. Malignant cases comprised 6 (14.0%) cases which included 2 (4.7%) cases of melanoma, 2 (4.7%) cases of pigmented basal cell carcinoma and 1 (2.3%) case each of basaloid squamous cell carcinoma and trichoblastic carcinoma each. Clinicopathological agreement could be seen in 32 (74.4%) cases. However, malignancy was clinically suspected in only half of histologically diagnosed cases. Conclusions Melanocytic nevi were the most common pigmented lesions diagnosed. Not all pigmented lesions are melanocytic in origin. Malignant tumors can sometimes appear deceptively benign and also tumors other than melanoma can be pigmented. Hence, histopathological examination remains the gold standard in diagnosing these conditions and guiding appropriate management. Keywords: melanocytic; melanoma; nevus; pigmented.  


Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 636
Author(s):  
Masato Tanaka ◽  
Sumeet Sonawane ◽  
Koji Uotani ◽  
Yoshihiro Fujiwara ◽  
Kittipong Sessumpun ◽  
...  

Background: Percutaneous biopsy under computed tomography (CT) guidance is a standard technique to obtain a definitive diagnosis when spinal tumors, metastases or infections are suspected. However, specimens obtained using a needle are sometimes inadequate for correct diagnosis. This report describes a unique biopsy technique which is C-arm free O-arm navigated using microforceps. This has not been previously described as a biopsy procedure. Case description: A 74-year-old man with T1 vertebra pathology was referred to our hospital with muscle weakness of the right hand, clumsiness and cervicothoracic pain. CT-guided biopsy was performed, but histopathological diagnosis could not be obtained due to insufficient tissue. The patient then underwent biopsy under O-arm navigation, so we could obtain sufficient tissue and small cell carcinoma was diagnosed on histopathological examination. A patient later received chemotherapy and radiation. Conclusions: C-arm free O-arm navigated biopsy is an effective technique for obtaining sufficient material from spine pathologies. Tissue from an exact pathological site can be obtained with 3-D images. This new O-arm navigation biopsy may provide an alternative to repeat CT-guided or open biopsy.


2021 ◽  
Vol 8 (33) ◽  
pp. 3054-3059
Author(s):  
Rajendra Prasad Jagannadham ◽  
Lakshmi Latchupatula ◽  
Sravani Ponnada ◽  
Neelima Lalam ◽  
Raghunadhababu Gudipudi ◽  
...  

BACKGROUND A variety of non - neoplastic and neoplastic conditions involve the nasal cavity, paranasal sinuses and nasopharynx and these are very common lesions encountered in clinical practice. Histopathological examination of these lesions is the gold standard for diagnosis because management and prognosis vary among different lesions. The aim of the present study was to evaluate the histopathological study of the lesions of the nasal cavity, paranasal sinuses and nasopharynx in relation to their incidence, age, gender and site wise distribution and to compare the results with the available data. METHODS A study of 88 cases was conducted for a period of 2 years from August 2017 to July 2019. After fixation, Processing and Haematoxylin and Eosin staining and special stains histopathological diagnosis was made. RESULTS Among 88 total cases, 58 were males and 30 were females. A male predominance was observed with a male to female ratio of 1.93 : 1. They were more common in third, fourth and fifth decade of life. Malignant nasal lesions were seen after fourth decade of life. Nasal lesions were more common in nasal cavity (67.05 %), followed by paranasal sinuses (18.18 %) and nasopharynx (14.75). Out of 88 total cases, 39 (44.32 %) were non - neoplastic, 30 (34.09 %) were benign and 19 (21.59 %) were malignant nasal lesions. CONCLUSIONS Sinonasal lesions and nasopharyngeal lesions can have various differential diagnoses. A complete clinical, radiological and histopathological correlation helps to categorize these sinonasal lesions into various non - neoplastic and neoplastic types. But histopathological examination remains the mainstay of definitive diagnosis. KEYWORDS Nasal Cavity, Paranasal Sinuses, Nasopharynx, Benign Tumours, Malignant Tumours, Histopathological Examination


Author(s):  
Seema Patel ◽  
Varsha J. Gattani ◽  
Ashok Z. Nitnaware

<p class="abstract"><strong>Background:</strong> There is high prevalence of thyroid lesions in India. In this study, an attempt is made to find out the clinical spectrum of thyroid swellings in central India, diagnostic accuracy of fine needle aspiration cytology (FNAC), appropriate surgical management and to compare it with postoperative histopathological diagnosis so as to determine its role in surgical management.</p><p class="abstract"><strong>Methods:</strong> In this prospective study, 100 subjects presenting to ENT OPD of GMC, Nagpur during the period from September 2017 to August 2019 with thyroid swelling who were fit to undergo surgery and willing to participate in the study were selected. After detailed evaluation and routine investigations, thyroid function test (TFT), FNAC, ultrasonography (USG) neck, all the subjects underwent required thyroidectomy. The postoperative histopathological examination (HPE) report was correlated with cytological report.  </p><p class="abstract"><strong>Results:</strong> In 100 subjects, majority of subjects were from 4th decade (32%) with female: male ratio=6.14:1. FNAC findings were colloid goiter (61%), nodular goiter (19%), follicular neoplasm (10%), and papillary carcinoma (9%). On HPE, colloid goitre (57%) was most common non-neoplastic lesion and papillary carcinoma (65.21 %) was most common malignant lesion. Hemithyroidectomy (70%) was most common procedure done. Transient hypocalcemia (5%), recurrent laryngeal nerve (RLN) paresis (2%) were the postoperative complications encountered. Sensitivity, specificity, accuracy, positive and negative predictive values of FNAC to diagnose malignancy were 55.6%, 100%, 91%, 100% and 90% respectively.</p><p class="abstract"><strong>Conclusions:</strong> FNAC is an easy, rapid, reliable, cost-effective, minimally invasive and readily repeatable technique for diagnosis of thyroid swellings. The common false negative diagnosis is seen in follicular pattern cases, cystic papillary thyroid carcinoma (PTC) and papillary microcarcinoma.  </p>


2019 ◽  
Vol 10 (1) ◽  
pp. 48-53
Author(s):  
Mohammad Sowkat Hossain ◽  
S M Mahbubul Alam ◽  
Sk Md Jaynul Islam ◽  
Wasim Selimul Haque ◽  
Shamoli Yasmin

Background: Undifferentiated tumours in the head and neck region are not uncommon. They can arise from different sites like in mucosa as well as in salivary glands, soft tissues or lymph nodes. Histopathological examination plays a central role in the diagnosis but difficulties arise with some tumours which are poorlydifferentiated due to their high inter- and intra-observer variability. In those cases, immunohistochemistry has greatly assisted to diagnose the tumours that cannot be accurately identified using routine histopathological procedures. The correct histopathological diagnosis is essential especially in case of malignant tumourwhere subsequent specific therapy is required. The aim of this study was to determine the role of immunohistochemistry for diagnosing undifferentiated malignancy in the head and neck region. Methods: This cross-sectional study was conducted during July 2014 to June 2015. A total of 35 Bangladeshi patient’s specimens of head and neck swelling were collected from two renowned laboratories in Dhaka city.These cases were diagnosed as undifferentiated tumour in histopathological examination.Standard protocol was followed for immunohistochemistry.Then primary immunohistochemical panel which included the markers for Epithelial CK (AE1/AE3),mesenchymal marker (Vimentin) and lymphoid marker (LCA) were used.The cases which were not resolved by primary immunohistochemistry panel, the second panel was applied for further sub classification (Desmin, Chromogranin, CK20, CEA, CD20, CD30, HMB45, NSE). Based on interpretation of immunohistochemical findings final diagnoses were made.Data analysis was performed using the Statistical Package for the Social Sciences for Windows version 22.0 (SPSS, Chicago, Illinois, USA). Results: A total of 35 undifferentiated tumorsof head-neck region were studied.The mean age was 46.3±17.6 years and male to female ratio was 4.8:1. The majority 13 (37.1%) patient had cervical lymphadenopathy, 11 (31.4%) had neck mass and 4(11.4%) had in nasal/sinonasal mass.Regarding histopathologicalcell types, round cell was 21 (60.0%), spindle cell 6 (17.1%), pleomorphic cells 6(17.1%) and epithelioid cells 2(5.7%). In initial histopathological examination, majority 25(71.4%) were undifferentiated malignant neoplasm, 8(22.8%) were metastatic undifferentiated carcinoma, 1(2.9%) was pleomorphic sarcoma and the remaining 1(2.9%) had malignant adnexal tumour. By application of immunohistochemistry, most (33, 94.3%) of the cases were resolved and the two cases remained unresolved. Among the resolved cases majority (15, 45.5%) were lymphoma, 4(12.1%) were metastatic carcinoma, 3(9.1%) were Ewing’s sarcoma and malignant melanoma were found in 3(9.1%) cases. Conclusion: This study supports that the immunohistochemical technique has a fundamental role in the investigation of undifferentiated tumour origin, to determine the correct guidance for treatment and improving the prognosis for head and neck tumour patients. Birdem Med J 2020; 10(1): 48-53


2020 ◽  
Vol 25 (2) ◽  
pp. 76-84
Author(s):  
Samia Quadir ◽  
Sabiha Quadir ◽  
Md Momin Uddin ◽  
Kazi Shameemus Salam ◽  
Mohammad Sazzad Hossain ◽  
...  

Background: Thyroid gland is the largest gland of the body which secretes thyroid hormones named T3 & T4. Incidence of solitary thyroid nodule is common in Bangladesh. Objectives: To validate the ultrasonography evaluation of solitary thyroid nodule comparing with histopathological diagnosis. Methodology: This cross sectional study enrolled 75 patients of age range between 14 to 72 years during July 2016 to June 2018 and the study was carried out in the department of Radiology & Imaging of Ultrasonography evaluation was finally compared with histopathological diagnosis which was considered as gold standard. Results: Among 75 patients are included in this study the age ranged between 14 to 72 years. Majority of the patients 37 (49.3%) were found between 31 to 40 years. 65 (86.3%) were female & 10 (13.3%) were male. All patients were presents with thyroid swelling. In USG findings Microcalcifications were present 9 (12%) in benign & 5(6.7%) in malignant cases. Presence of Halo were in all benign cases 14 (18.7%). Comet tail sign were in 5 (6.7%) in benign & 3 (4%) in malignant cases. Histological nodular goiter were 57 (76%), Follicular adenoma 8 (10.7%), Thyroditis 5 (6.7%) and Papillary carcinoma 4 (5.3%), Follicular Carcinoma 1 (1.3%). Conclusion: This cross sectional study was carried out with an aim to determine the usefulness of ultrasonogram diagnosis of solitary thyroid nodule compared with histopathology findings. As the validity test results are higher, it can be concluded that the ultrasonogram is a useful diagnostic modality in the evaluation of solitary thyroid nodule. Bangladesh J Otorhinolaryngol; October 2019; 25(2): 76-84


Author(s):  
Vikrant Mittal ◽  
Manish Munjal ◽  
Rohit Verma ◽  
Parth Chopra ◽  
Hemant Chopra

<p class="abstract"><strong>Background:</strong> Vocal cords are the most common site of laryngeal pathologies. Hoarseness is the sentinel symptom for lesions affecting the glottis. The aim of this study was to categorize various types of lesions affecting the glottis in patients undergoing microlaryngeal surgery. Patients’ demographic profile, gender, occupational factors were studied. Clinical, microlaryngeal and histopathological correlation of the lesions was done.</p><p class="abstract"><strong>Methods:</strong> 50 patients with glottic pathologies undergoing microlaryngeal surgery were included. Patients underwent detailed examination including indirect laryngoscopy, flexible fibreoptic laryngoscopy, followed by microscopic laryngeal examination under general anaesthesia. The lesions were excised using standard microlaryngeal instruments and the specimens were subjected to histopathological examination. The data was analysed.  </p><p class="abstract"><strong>Results:</strong> There was male preponderance (male: female ratio of 1.27:1). Housewives formed the largest group (28%). Commonest pathologies were vocal nodules (34%), vocal polyps (22%) and carcinoma (22%). Microlaryngoscopy was found to be the best means of visualizing the lesions and reaching a clinical diagnosis. In 10 (20%) patients, the final histopathological diagnosis was different from clinical diagnosis.</p><p class="abstract"><strong>Conclusions:</strong> In this study, vocal nodules were the commonest lesions to affect the glottis. Microlaryngoscopy proved to be the best method for examination. Also, there was discrepancy in the clinical and histopathological diagnosis in 20% cases.</p>


2018 ◽  
Vol 8 (2) ◽  
pp. 1353-1359
Author(s):  
Diksha Karki ◽  
Abhimanyu Jha ◽  
Shreya Shreevastav ◽  
Dinesh B Pokhrel

Background: Tumours and tumour like lesions of skin have overlapping clinical presentation and sometimes pose a diagnostic difficulty on clinical ground alone. Histopathological examination although helpful to arrive at correct diagnosis, at times may be treacherous and may require ancillary tests such as Immunohistochemistry.Materials and Methods: The study was conducted at Department of Pathology of Tribhuvan University Teaching Hospital. It was a one year prospective study which enrolled 238 cases of skin biopsies after histopathological confirmation of tumours and tumour like lesions. The specimens were processed by standard method and Hematoxylin and Eosin stained sections were examined. Data entry and analysis was done by using SPSS 20 version.Results: Epidermal cyst was commonest lesion (11.8%). Among benign tumours squamous papilloma was most frequent while Pilomatricoma and Spiradenoma were most common adnexal tumour. Squamous cell carcinoma constituted 41.8% and was commonest malignant tumour followed by basal cell carcinoma (30.2%). Benign tumours were common in 11-30 years of age, malignant tumours in 61-80 years of age while tumour like lesions were common in 21-30 years of age.Conclusion: Squamous papilloma and squamous cell carcinoma was the most common benign and malignant tumour respectively. Benign adnexal tumours exceeded malignant one and were seen in third decade of life. Epidermal cyst was the commonest tumour like lesions followed by dermoid cysts.


2019 ◽  
Vol 6 (12) ◽  
pp. 4485
Author(s):  
Virendra Athavale ◽  
Sree Kumar Balasubramanian ◽  
Trupti Tonape ◽  
Shivamurti Khandalkar ◽  
Keerti Ramesh ◽  
...  

Background: Swellings in the neck are common and are encountered frequently in General Surgery. A diagnosis may be possible based on clinical examination alone but, investigations are required to clarify the diagnosis and, to exclude a diagnosis of malignancy. With this background, the present study is conducted in an effort to find out the causes for non-thyroidal neck swellings, and to assess the various investigations and management available for treating these neck swellings.Methods: The study was conducted on newly diagnosed non thyroidal neck swelling cases coming to the Dept. of General Surgery, ENT, Oro- Maxillofacial and Pulmonary Medicine (OPD and IPD), Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune. The study was conducted from July 2017 to July 2019. Data collection included history taking, clinical examination, and radiological investigation and histopathological examination by specific pathologist throughout the study. After confirmation of diagnosis, patients were subjected to further management.Results: Among 100 patients, male to female ratio was 1:1. The Mean age of the participants is 40.41±12.85 years. There was statistically significant association between tobacco addiction and malignant neck swelling. Considering HPE as gold standard, the sensitivity and specificity of fine needle aspiration cytology (FNAC) diagnosis is 81.8% and 100% respectively.Conclusions: The overwhelming amount of possible diseases linked to a swelling in the neck, makes it of utmost importance to follow a strict protocol for appropriate diagnosis making and prompt treatment so as to prevent diagnostic delay. 


Sign in / Sign up

Export Citation Format

Share Document