scholarly journals Non-malignant Oral Ulcer: A Diagnostic Challenge to Otorhinolaryngologists

2019 ◽  
Vol 27 (3) ◽  
pp. 223-228
Author(s):  
Neeraj Aggarwal ◽  
Sirshak Dutta ◽  
Avijit Choudhury ◽  
Mainak Dutta ◽  
Saumik Das ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Clinical Diagnosis ◽  
Histopathological Examination ◽  
Oral Candidiasis ◽  
Tertiary Care ◽  
Diagnostic Challenge ◽  
Erosive Lichen Planus ◽  
Male Preponderance ◽  
Malignant Lesions ◽  
Malignant Ulcer

Introduction Apart from the malignant ulcers a wide variety of dermatological and other systemic conditions can affect oral cavity and often be a diagnostic challenge due to their similar presenting features and appearance. Despite being benign, some of them may be fatal if not diagnosed and treated timely. This study aims to assess the incidence of different non malignant ulcers in oral cavity and to estimate the need for histopathological examination for confirmation of the condition for proper management. Materials and Methods  An institution based observational study was conducted over a time period of 16 months at a tertiary care institute. Total 172 cases were included in the present study irrespective of age, sex and duration. Malignant lesions were excluded from the study. Results The present study shows a slight male preponderance (M:F = 1.48:1) with majority of cases were in age group 20-40 years of age (43.02%). Most commonly encountered were recurrent aphthous stomatitis (27.9%) followed by erosive lichen planus (16.28%), oral candidiasis, angular stomatitis, traumatic ulcers and others. 78.5% were treated successfully on the basis of clinical diagnosis while 21.5% cases needed further histopathological or other investigation for confirmation of diagnosis. Conclusion Though the otolaryngologists are more concerned about malignant ulcer, there are many non malignant ulcers which can cause significant morbidity and can even be fatal and should be given similar importance like malignant lesions. Majority of them can be treated successfully on the basis of clinical diagnosis but histopathological examination may be required in some cases for proper diagnosis and appropriate management.

A prospective observational study on the effectiveness of risk of malignancy index score (RMI 3) in a tertiary care centre in Eastern India

2020 ◽  
Vol 11 (5) ◽  
pp. 54-60
Author(s):  
Apurba Mandal ◽  
Shibram Chattopadhyay ◽  
Sushanta Mondal ◽  
Arunava Biswas
Keyword(s):  
Ovarian Cancer ◽  
Adnexal Mass ◽  
Malignant Tumors ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Ca 125 ◽  
Tertiary Care Centre ◽  
Gynecology And Obstetrics ◽  
Risk Of Malignancy ◽  
Malignant Lesions

Background: Adnexal mass is a common presentation in today’s gynecological practice. The incidence of ovarian cancer is increasing day by day and diagnosis is often difficult to be made pre operatively with inadequate surgical exploration is a regular occurrence. Aims and Objectives: To assess and validate the importance of RMI-3 score as pre-operative diagnostic tool of differentiating benign from malignant adnexal mass for starting first line therapy of ovarian cancer and to find out the incidences of ovarian malignancy among study population. Material and Methods: The study was conducted in the Department of Gynecology and Obstetrics on (n=115) patients attending GOPD and indoor with adnexal mass fulfilling the inclusion and exclusion criteria using purposive sampling technique. All the selected cases underwent ultrasonography and serum CA- 125 level estimation necessary for calculating RMI score. A score of >200 was taken as suggestive of malignancy and confirmatory diagnosis was performed by histopathological examination obtained from staging laparotomy of adnexal mass. The individual scores were then correlated with final outcomes with statistical analyses. Results: The study revealed benign ovarian tumors are more under 50 years (78.46%) and patients with normal BMI are diagnosed with maximum of malignancy (n = 28). History of tubal ligation carried less risk of malignancy (p<0.0001). Histologically malignant tumors found mostly in 71.4% postmenopausal group whereas 94.1% benign pathology were present in perimenopausal group and there is no association found between parity and histopathology (p=0.058). Bilateral (p=0.013), multilocular (p=0.000) tumors with solid areas (p<0.0001) and thick papillary projections (p<0.0001) had statistically significant association with malignant lesions. RMI score (>200) had more efficacy than serum CA-125 level (>46) in differentiating malignant lesions from benign one in terms of specificity (96% vs 83.87%) and positive predictive value (95% vs 79.17%). Conclusions: RMI-3 score is a simple, reliable and effective tool in differentiating benign from malignant adnexal masses thereby help in quick referral and management of cases with increase chances of survival of the patients.

scholarly journals Nasomaxillary swellings: our experience at tertiary care hospital

2021 ◽  
Vol 7 (3) ◽  
pp. 469
Author(s):  
Mukesh Rawat ◽  
Archana Lall ◽  
Kavita Sachdeva
Keyword(s):  
Tertiary Care Hospital ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Final Diagnosis ◽  
Inverted Papilloma ◽  
Nasal Endoscopy ◽  
Common Symptom ◽  
Fungal Sinusitis ◽  
Care Hospital ◽  
Malignant Lesions

<p class="abstract"><strong>Background:  </strong>A wide spectrum of lesions may present as nasomaxillary swellings ranges from benign to malignant lesions including fungal sinusitis and fibro vascular lesions example: JNA (Juvenile nasopharyngeal angiofibroma) and Inverted papilloma. Many Pathologies ranging from benign to malignant tumors may mimic a simple Nasomaxillary mass. It is diagnostic challenge to determine pathology behind it. A detailed clinical evaluation with nasal endoscopy and relevant pre-operative investigations including radiological imaging and histopathological examination is essential to reach up to final diagnosis. The aim of the study was to do clinicopathological evaluation of patients presenting with nasomaxillary swelling and correlation of clinical, radiological and Histopathological findings.</p><p class="abstract"><strong>Methods: </strong>This was a prospective observational study on 50 nasomaxillary swelling patients who are presented in the Department of ENT and Head and Neck Surgery of N.S.C.B. MCH Jabalpur, a tertiary care Hospital, between March 2018 to August 2019. A detailed history taking and clinical examination with nasal endoscopy and relevant preoperative investigations including CECT Nose and PNS and histopathological examination was done in all patients.</p><p class="abstract"><strong>Results: </strong>50 Nasomaxillary swelling patients were selected for this study. 30 patients were male and 20 were females. Ages of patients were varied from 12 years to 72 years. 23 patients (46%) were malignant and 27 (54%) were benign. Histopathological examination results shows benign lesions like JNA (6 cases), fungal sinusitis (6 cases), dermoid cyst (1 case), inverted papilloma (3 cases), sebaceous cyst (1 case), jaw lesions (10 cases), (odontogenic like radicular/ infected cyst, dentigerous cyst, cystic ameloblastoma and non-odontogenic like fibrous dysplasia) and malignant lesions like SCC (squamous cell carcinoma) (12 cases), spindle cell sarcoma (2 cases), undifferentiated carcinoma (3 cases), adenocarcinoma (3 cases), adenoid cystic carcinoma (1 case), Invasive pleomorphic sarcoma (1 case) and malignant melanoma (1 case). SCC was most common lesion f/b JNA and fungal sinusitis. Well differentiated SCC was most common histological type (10 out of 12 cases of SCC). Most common symptom was nasal obstruction (66% cases) f/b epistaxis (52% cases) but epitasis was most common symptom among malignant and JNA cases. In 6 cases (3 JNA, 1 inverted papilloma, 1 malignancy and 1 radicular cyst) radiological diagnosis were not correlated with histological findings.</p><p class="abstract"><strong>Conclusions: </strong>Most our cases were malignant nasomaxillary lesions followed by fungal sinusitis and JNA. Most patients presented in advanced stage of disease so rapidly evaluation including nasal endoscopy should be done. CECT scan is essential to determine tumors extent and bony lesions. All patients should undergo hisotopatholigical examination. The final diagnosis should be made on the basis of clinical, radiological and histopathological findings.</p>

scholarly journals The Frequency and Causes of Subepidermal Gaps or Blisters and the Compliance Rate Between Clinical Diagnosis and Pathology Reports from 2015 to 2019

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Abbas Darjani ◽  
Hojat Eftekhari ◽  
Seyedeh Rojin Amini Rad ◽  
Narges Alizadeh ◽  
Rana Rafiee ◽  
...  
Keyword(s):  
Clinical Diagnosis ◽  
Skin Diseases ◽  
Histopathological Examination ◽  
Compliance Rate ◽  
Clinical Manifestations ◽  
Final Diagnosis ◽  
Direct Immunofluorescence ◽  
Diagnostic Challenge ◽  
Cross Sectional ◽  
Pathology Reports

Background: Skin diseases are the fourth most common cause of human illness, and blisters with different clinical manifestations make a diagnostic challenge. Objectives: This study aimed to evaluate the frequency and causes of subepidermal gaps or blisters, as well as the compliance rate between the initial and final clinical diagnoses based on pathology reports. Methods: In this cross-sectional study, pathology reports of subepidermal blisters or gaps were evaluated in the patients referred to the Razi Laboratory of Rasht from 2015 to 2019. The samples were examined by a pathologist after hematoxylin and eosin staining. The reports included demographic information, clinical differential diagnoses, final diagnosis, direct immunofluorescence findings, and salt split results. Finally, the compliance rate of clinical diagnosis with pathology reports was determined. Results: A total of 183 pathology reports were evaluated, 170 of which contained the final diagnosis. Females were more frequently affected by the disease, and pemphigoid bolus and lichen planus were the most prevalent final diagnoses. The compliance rate between the initial and final diagnoses was 94%. About 37.2% of the reports lacked direct immunofluorescence (DIF) and salt split, and only 42.6% of the samples had undergone DIF examination, while 20.2% had both DIF and salt split. There was no significant association between the compliance rate of the final diagnosis with age, sex, and undergoing diagnostic tests. Conclusions: A high incidence of subepidermal gaps or blisters was seen in middle-aged individuals and females. The compliance rate of the initial clinical diagnosis with the final diagnosis based on pathological reports was high. Our findings emphasize the importance of histopathological examination and the complementary role of direct immunofluorescence and salt split in diagnosis.

scholarly journals A retrospective clinico-pathological study of hysterectomy cases in a tertiary care hospital in India – a review of 950 cases.

2018 ◽  
Vol 17 (1) ◽  
pp. 88-92
Author(s):  
Pal Subrata ◽  
Chakrabarti Srabani ◽  
Sinha Anuradha ◽  
Phukan Jyoti Prakash ◽  
Bose Kingshuk ◽  
...  
Keyword(s):  
Clinical Diagnosis ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Medical Science ◽  
Abdominal Hysterectomy ◽  
Uterine Bleeding ◽  
Histopathological Diagnosis ◽  
Care Hospital ◽  
Dysfunctional Uterine Bleeding ◽  
Common Indication

Introduction: Hysterectomy is the most commonly performed gynaecological surgery in India as well as in abroad. It is frequently done in myometrial and endometrial pathologies and rarely for other causes. Hysterectomy is definitive management for diseases like fibroid, adenomyosis, dysfunctional bleeding, prolapsed uterus and malignant lesions of uterus and adenexa. We aimed our study to observe incidence of different pathologies of uterus and other reproductive organs in hysterectomy specimens and retrospective correlation between clinical diagnosis and histopathological finding of hysterectomy cases.Materials and Methods: Retrospective data were collected from our routine histopathological laboratory. Detailed history, clinical examination and operative findings and provisional diagnosis of all 950 hysterectomy cases were recorded during study period of 2 years. Histopathological diagnosis was correlated with clinical and preoperative diagnosis.Observations: Abdominal hysterectomy (734 cases, 77.26%) was the most common route of approach during surgery. Common pre-operative diagnoses were fibroid uterus (32%), dysfunctional uterine bleeding (28.95%), uterine prolapsed (22.74%). Other causes included uterine polyps (1.6%), complications of pregnancy (2.74%), ovarian tumours (8.42%), cervical carcinomas (2.97%) etc. Common pathologies on histology were leiomyoma (32%), adenomyosis (20.32%), atrophic endometrium (17.26%) and endometrial pathology (8.95%).Discussion: Our study has been correlated with other studies of India and other south Asian countries. Most common indication of hysterectomy in our study is dysfunctional uterine bleeding (32%) but Gupta et al and Jha R et al found utero-vaginal prolapse as most common indication. Leiomyoma was the most common histology diagnosed in the present series. Clinical diagnosis was possible in 67.57% cases in our study similar to Khan et al (70.51%).Conclusions: Histopathological examination of hysterectomy specimens helps to detect the exact causes and underlined pathology.Bangladesh Journal of Medical Science Vol.17(1) 2018 p.88-92

scholarly journals Study of glottic lesions in patients undergoing microlaryngeal surgery

2020 ◽  
Vol 6 (2) ◽  
pp. 277
Author(s):  
Vikrant Mittal ◽  
Manish Munjal ◽  
Rohit Verma ◽  
Parth Chopra ◽  
Hemant Chopra
Keyword(s):  
Clinical Diagnosis ◽  
Histopathological Examination ◽  
Detailed Examination ◽  
Histopathological Diagnosis ◽  
Female Ratio ◽  
Histopathological Correlation ◽  
Male Female Ratio ◽  
Male Preponderance ◽  
Vocal Nodules ◽  
Microlaryngeal Surgery

<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>

scholarly journals Verrucopapillary Lesions of the Oral Cavity: A Review

2020 ◽  
Vol 4 (7) ◽  
pp. RV1-RV7
Author(s):  
Sana Khaled ◽  
Santosh R. Bharadwaj ◽  
Bushra Anjum ◽  
Satyanarayana D.
Keyword(s):  
Oral Cavity ◽  
Human Papilloma Virus ◽  
Oral Mucosa ◽  
Diagnostic Approach ◽  
Diagnostic Challenge ◽  
Papilloma Virus ◽  
Histopathological Features ◽  
Potentially Malignant ◽  
Malignant Lesions

Verrucopapillary lesions are a spectrum of benign, potentially malignant and malignant lesions of the oral mucosa which usually are misdiagnosed. They pose a great diagnostic challenge mainly due to confusing terminology and also due to similar clinical and histopathological features which often makes these lesions indistinguishable from one another. The human papilloma virus (HPV) plays a important role in the pathogenesis of majority of these lesions. This review aims to summarize and highlight the key clinical and histopathological features of these lesions, and also provides a diagnostic approach to these entities.

scholarly journals Role of Cross-sectional Imaging (CT/MRI) in Characterization and Distinguishing Benign from Malignant/Potentially Malignant Cystic Lesions of Pancreas

2020 ◽  
Vol 10 ◽  
pp. 28
Author(s):  
Amy Sara Abraham ◽  
Betty Simon ◽  
Anu Eapen ◽  
Kirthi Sathyakumar ◽  
Anuradha Chandramohan ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Tertiary Care ◽  
Multivariate Logistic Regression Analysis ◽  
Mucinous Cystadenoma ◽  
Cystic Lesions ◽  
Cross Sectional ◽  
Potentially Malignant ◽  
Cross Sectional Imaging ◽  
Malignant Lesions ◽  
Sectional Imaging

Objectives: The aim of the study was to evaluate the accuracy of computed tomography/magnetic resonance imaging (CT/MRI) in characterizing cystic lesions of the pancreas and in differentiating between benign and malignant/potentially malignant lesions. Material and Methods: A retrospective study was performed on patients with pancreatic cystic lesions who underwent pre-operative imaging and surgery between October 2004 and April 2017 at a tertiary care teaching hospital. The images were reviewed for specific characteristics and diagnoses recorded independently by two radiologists who were blinded to the histopathological examination (HPE) report. Radiological diagnostic accuracy was assessed with HPE as reference standard. Results: A total of 80 patients fulfilled the inclusion criteria (M: F = 27:53). The final HPE diagnoses were solid pseudopapillary neoplasm (32.5%), walled off necrosis/pseudocyst (27.5%), mucinous cystadenoma (15%), serous cystadenoma (11.25%), intraductal papillary mucinous neoplasm (8.75%), mucinous cystadenocarcinoma (2.5%), simple epithelial cyst (1.25%), and unspecified benign cystic lesion (1.25%). Observer1 correctly identified the diagnosis in 73.75% of cases while observer 2 did so in 72.5%. Sensitivity for distinguishing benign versus malignant/potentially malignant lesions was 85.1% for observer 1 and 80.9% for observer 2. On multivariate logistic regression analysis: Solid cystic morphology, presence of mural nodule, and female gender were associated with premalignant/malignant lesions. Conclusion: Cross-sectional imaging is a valuable tool for characterization of pancreatic cystic lesions within its limitations.

Oral mucocele in infant with an unusual presentation

2020 ◽  
Vol 13 (6) ◽  
pp. e234669
Author(s):  
Rishi Suryavanshi ◽  
Ahsan Abdullah ◽  
Neerja Singh ◽  
Madhusudan Astekar
Keyword(s):  
Oral Cavity ◽  
Salivary Glands ◽  
Clinical Diagnosis ◽  
Rare Case ◽  
Histopathological Examination ◽  
Benign Lesion ◽  
Unusual Presentation ◽  
Mucous Secretion ◽  
Minor Salivary Glands ◽  
Great Role

Mucocele is a benign lesion characterised by an extravasation or retention of mucous secretion in submucosal tissue from minor salivary glands. The occurrence of mucocele is common in the oral cavity, with more than 70% of cases on lower labial mucosa. The occurrence of mucocele on the tongue is considered rare and accounted for only 2.25% in the previous literature. Histopathological examination plays a great role in the confirmation of the clinical diagnosis. Management of mucocele is at times challenging. This paper highlights a rare case of mucocele in a 5-month-old infant who was successfully managed under day-care anaesthesia.

scholarly journals Prostatic lesions: Histopathological study in a tertiary care hospital

2018 ◽  
Vol 4 (1) ◽  
pp. 12-19
Author(s):  
S. Bhatta ◽  
S. Hirachan
Keyword(s):  
Histopathological Examination ◽  
Benign Lesion ◽  
Tertiary Care ◽  
Histopathological Study ◽  
P Value ◽  
Care Hospital ◽  
Significant Difference ◽  
Nodular Hyperplasia ◽  
Malignant Lesions ◽  
The Mean

Background: Prostatic lesions like Nodular hyperplasia of prostate, inflammation and carcinoma are common causes of morbidity and mortality in males. The incidence of these lesions increases with age. This study was conducted with the objective of evaluating histopathological pattern of prostatic lesions.Methods: This was a retrospective study conducted at KIST Medical College from Jan 2014 to Jan 2018. The study included ninety six prostatic specimens received in department of pathology. Hematoxylin and Eosin stained slides were retrieved and reviewed. The specimens and slides were analyzed according to type of specimen, age of patient, histopathological pattern and final diagnosis. Results were analyzed using Statistical Package for Social Science (SPSS, version 21) for Windows. Independent t test was used to correlate the mean age between patients with benign and malignant lesions. P value less than 0.05 was considered as statistically significant.Results: The most common benign lesion was nodular hyperplasia of prostate 86(89.58%). Malignant lesions comprised 8 (8.34%) cases of all prostatic lesions. All the cases of prostate carcinoma were adenocarcinoma. The most frequent Gleason score was 9. Mean age for benign and malignant lesions were 69.6 ± 8.1 years and 72.9 ± 5.2 years respectively. There was no significant difference in the mean age between patients with benign and malignant lesions (p value 0.27).Conclusion: Benign lesions of prostate are more common than malignant lesions. Histopathological examination of prostate specimens have important role in diagnosing various benign and malignant lesions, especially to rule out incidental carcinoma.JMMIHS.2018;4(1):12-19

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