Clinicopathological and Radiological Profile of Multinodular Goitre – A Prospective Study

Introduction Multinodular goitre (MNG) is defined as multiple palpable distinct nodules in the enlarged thyroid gland. MNG can harbour malignancy in 1-10% cases. We undertook the present study to correlate the clinical, radiological and cytological features of MNG with that of final histopathological diagnosis. Materials and Methods A prospective cohort study was done in a tertiary care hospital in northern part of West Bengal from January 2018 to December 2019. Patients aged between 12 years and 75 years, presenting with MNG on clinical examination, were included in the study. We compared the pre-operative ultrasonography (USG) of neck and fine needle aspiration cytology (FNAC) reports with post-operative histopathological examination (HPE) report. Results Among 100 patients 80 were female and 20 were male. Most patients were in 41-50 years age group. For detection of malignancy in MNG, USG had 40% sensitivity, 97.78% specificity, 66.67% positive predictive value (PPV), 93.62% negative predictive value (NPV), and 92% diagnostic accuracy. Sensitivity, specificity, PPV, NPV and diagnostic accuracy of FNAC for detection of malignancy in MNG were 20%, 93.33%, 25%, 91.3% and 86% respectively. When USG features were combined with FNAC features non-diagnostic result decreased from 6% to 2% and diagnostic accuracy for detecting malignancy in MNG increased from 86% to 90%. Conclusion USG and FNAC are complementary to each other in the diagnostic workup of MNG. USG guided FNAC is still better for reaching final diagnosis and exclusion of malignancy.

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RAPID URINE TRYPSINOGEN-2 DIPSTICK ASSAY TO DIAGNOSE ACUTE PANCREATITIS IN EMERGENCY SETUP

10.36106/ijsr/4800967 ◽

2020 ◽

pp. 1-4

Author(s):

Shankar. S ◽

Kolandasamy. C ◽

Srinivasan.U. P ◽

Naganath babu O. L.

Keyword(s):

Acute Pancreatitis ◽

Diagnostic Accuracy ◽

Predictive Value ◽

Tertiary Care ◽

Care Hospital ◽

Dipstick Test ◽

Early Management ◽

Laboratory Investigations ◽

Set Up ◽

Sensitivity Specificity

Background: Early diagnosis of acute pancreatitis remains a challenge in emergency set up. The early management results in better outcomes but none of the available investigations were rapid and accurate to guide the management in these patients. Hence in suspected cases of acute pancreatitis, the urinary trypsinogen 2 dipstick assay can be used to diagnose them at the earliest in the Emergency setup. The purpose of this study is to determine the accuracy of urine trypsinogen 2 assay in diagnosing acute pancreatitis. Methods: The patients presenting with symptoms consistent with acute pancreatitis to the emergency department, at a tertiary care hospital in Southern India between November 2018 to November 2019 were included in a prospective observational study after obtaining Institutional ethical committee clearance. In addition to the routine investigations done in cases of acute abdomen, patients underwent urine trypsinogen 2 dipstick test. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) were calculated. Results were compared. Results: A total of 50 cases were included in the study. The urine trypsinogen 2 dipstick test was positive in 35 of 37 patients with acute pancreatitis (sensitivity, 94.59%) and in none of 13 patients with abdominal pain but without any evidence of acute pancreatitis (specificity, 100%). The diagnostic accuracy of the urine trypsinogen 2 dipstick test was 96% in this study higher than other conventional laboratory investigations. Conclusion: This study shows that the dipstick test has high diagnostic accuracy and can be considered for regular use for diagnosing pancreatitis along with the conventional methods.

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A two year retrospective study of cytohistopathological correlation of cervical smear in a tertiary care hospital

Asian Journal of Medical Sciences ◽

10.3126/ajms.v12i8.36940 ◽

2021 ◽

Vol 12 (8) ◽

pp. 144-148

Author(s):

Anil Kumar Sirasagi ◽

Arpitha K ◽

Saara Neha ◽

Pratima Manohar Pattar

Keyword(s):

Cervical Cancer ◽

Predictive Value ◽

Pap Smear ◽

Tertiary Care ◽

Histopathological Diagnosis ◽

Pap Smears ◽

Care Hospital ◽

Cervical Smear ◽

Cervical Lesions ◽

Sensitivity Specificity

Background: Cervical cancer in women is the second most common cancer and the commonest cause of mortality in developing countries. The introduction of Pap smear test changed the scenario of cervical cancer with an intense drop in the incidence and mortality due to invasive cervical cancer. Aims and Objective: To evaluate the patterns of cervical smear cytology and to correlate the cervical smear diagnosis with histopathological diagnosis and to assess the efficacy of Pap smears in diagnosing cervical lesions. Materials and Methods: This two-year retrospective study (January 2018 to December 2019) was done in the department of Pathology in a tertiary care hospital. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated considering histopathological diagnosis of cervical biopsy as the gold standard. Results: A total of 316 Pap smears were studied, out of which we selected 154 cases who also undergone biopsy or hysterectomy. Epithelial cell abnormalities (ECA) were found in 28 cases (18.2%). Among this the most common ECA was Atypical squamous cells of undetermined significance (ASCUS) seen in 10 cases (6.5%) followed by LSIL (5.2%), HSIL (3.2%) and SCC of cervix (3.2%). The overall correlation between cervical cytology and histopathology was found in 125 out of 154 cases (81.16%). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of pap smear was 90.57%, 62.50%, 95.41%, 43.47% and 87.66% respectively. Conclusion: Pap smear is a simple, safe, non-invasive and effective method for detection of lesions of the cervix and ECA. Hence, better awareness and periodical cytological screening programs can help in the early detection of malignant cervical lesions and thereby reducing the morbidity and mortality related to this malignancy.

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Cytopathological and histopathological evaluation of neck mass in a tertiary care hospital

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20213275 ◽

2021 ◽

Vol 7 (9) ◽

pp. 1432

Author(s):

Yaladahalli G. Lokesh ◽

Dudda Ravi ◽

Hodeyala J. Srikanth

Keyword(s):

Diagnostic Tool ◽

Predictive Value ◽

Tertiary Care ◽

Needle Aspiration ◽

Neck Mass ◽

Care Hospital ◽

Neck Masses ◽

Cytological Features ◽

Needle Aspiration Cytology ◽

Sensitivity Specificity

Background: Patients with neck swellings are commonly seen in ENT outpatient and leads to dilemma in diagnosis. To prevent unnecessary investigations and surgery a simple and sensitive diagnostic tool is needed. Fine needle aspiration cytology (FNAC) is a simple and sensitive diagnostic tool that can provide results in minutes.Methods: This prospective study was done at the department of ENT, Mandya institute of medical sciences, Mandya, Karnataka, India from November 2017 to April 2019 including 100 cases of neck masses in patients aged above 18 years. FNAC was done for all neck masses and then these cases were subjected for biopsy. The cytological features was then reviewed with corresponding histopathology features.Results: Out of the 100 neck masses under study 67 (67%) were males and 33 (33%) were females with male:female ratio (1:2.03). Thyroid aspirations (43%) were most common followed by lymph node (24%), salivary gland aspirations (18%), congenital swellings (8%) and others (7%). Out of the 100 cases 26% were neoplastic and 74% were non-neoplastic. Histopathological correlations were available in all the 100 cases with sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 84.2%, 98.65%, 95.65% and 94.81% respectively. FNAC was in correlation with histopathology in 86% of cases and found to be statistically significant.Conclusions: FNAC is safe, simple and minimally invasive first line investigation of choice for the patients presenting with palpable neck masses and can provide results rapidly and but histopathology remains the gold standard.

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Diagnosis of Pulmonary Tuberculosis in Resource Limited Setting of Rawalpindi

The Open Microbiology Journal ◽

10.2174/1874285801812010376 ◽

2018 ◽

Vol 12 (1) ◽

pp. 376-380

Author(s):

Fatima Zahra ◽

Aamer Ikram ◽

Gohar Zaman ◽

Luqman Satti ◽

Farida Lalani ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Predictive Value ◽

Tertiary Care ◽

Fluorescent Microscopy ◽

Simultaneous Detection ◽

Smear Microscopy ◽

Care Hospital ◽

Indicator Tube ◽

Resource Limited ◽

Sensitivity Specificity

Introduction:Tuberculosis is an infectious disease with a high prevalence of about 9 million cases occurring annually. Ziehl Neelsen microscopy is the most widely used technique to detect Acid Fast Bacilli, but it is less sensitive. However, fluorescent microscopy is more helpful with simple diagnostic criteria. Gene Xpert®MTB/RIF assay is a rapid molecular assay that enables diagnosis of Tuberculosis with simultaneous detection of rifampicin resistance. Owing to this fact, we aimed at evaluating the diagnostic accuracy of Ziehl Neelsen microscopy, fluorescent microscopy and Xpert MTB/RIF keeping MTB culture (Mycobacterial Growth Indicator Tube) as a gold standard for the diagnosis of tuberculosis.Methodology:This study was carried out at a tertiary care hospital of Rawalpindi in the year 2016. Patients aged 18 to 70 years irrespective of gender with suspected TB based on history, clinical and radiological examination were included in the study. Respiratory clinical specimens including sputum, Broncho-Alveolar Lavage (BAL), and endobronchial washings were collected. Specimens were processed by MGIT (MTB culture), ZN microscopy, fluorescent microscopy and Gene Xpert MTB/RIF assay.Results:A total of 352 respiratory specimens were tested among which 160 (45%) samples were positive by culture. Out of culture positive samples, 158 samples (98.7%) were GeneXpert TB positive while 2 were negative. While only 49 (30.6%) were positive on ZN microscopy and 89 (55%) were positive on fluorescent microscopy. Out of the culture negative samples, 2 were positive with ZN microscopy, one was positive with fluorescent microscopy and 3 were positive on Gene Xpert. Sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV) and diagnostic accuracy of ZN Smear microscopy was 39%, 99.5%, 96%, 63% and 14.5% respectively. Sensitivity, specificity, PPV, NPV and diagnostic accuracy of fluorescent smear microscopy was 55% and 99.5%, 98%, 72% and 79% respectively. Sensitivity, specificity, PPV, NPV and diagnostic accuracy of Gene XPERT was 98% and 99%, 98%, 99% and 98% respectively.Conclusion:In countries like Pakistan where Tuberculosis is endemic, the diagnostic accuracy with highest sensitivity and specificity was Gene Xpert Polymerase Chain Reaction (PCR) MTB/RIF assay which can help in well-timed diagnosis of the disease.

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F.N.A.C. AS DIAGNOSTIC TOOL OF PAROTID TUMORS AND ASSOCIATED PITFALLS IN CORRELATION WITH HISTOPATHOLOGY

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i1.1153 ◽

2020 ◽

Vol 4 (1) ◽

Author(s):

Bhawana Pant ◽

Sanjay Gaur ◽

Prabhat Pant

Keyword(s):

Preoperative Diagnosis ◽

Histopathological Examination ◽

Clinical Information ◽

Final Diagnosis ◽

Needle Aspiration ◽

Histopathological Diagnosis ◽

Cytological Diagnosis ◽

Tertiary Referral Centre ◽

Clear Cut ◽

Parotid Tumors

F.NA.C has been used for ages as a safe and economical tool for fast preoperative diagnosis of parotid tumors. It has certain pitfall which sometimes leads to misdiagnosis and consequently it may have affect on treatment of the tumors. Keeping in view of the diverse classification of parotid tumors’ information from cytology should be combined with radiology as well as clinical diagnosis. Aim: To discuss some cases where there was discrepancy between cytological diagnosis and histopathological result and also suggest measures to improve the efficacy of F.N.A.C. Material and methods: The study includes 50 cases of parotid tumours who presented to the department of ENT at Government medical college Haldwani which is a tertiary referral centre during 2009 to 2016. Only adult patients were included and inflammatory swelling were excluded from the study. All patients evaluated Contrast enhanced computerized tomography(CECT) and Magnetic resonance imaging (MRI) followed by Fine needle aspiration cytology .Preoperative diagnosis was made upon the findings of the above investigations and different types of parotid surgeries were done. . Final diagnosis was made on histopathological examination. Result :The most common tumour came out to be pleomorphic adenoma (23 cases-46%) followed by mucoepidermoid carcinoma(12cases-24%). In ten cases there was no clear cut association between cytological diagnosis and final histopathological diagnosis. Conclusion: FNAC is highly sensitive and specific technique for diagnosis of many salivary gland swellings. FNAC can be used preoperatively to avoid unnecessary surgery and biopsy. Details of clinical information and radiologic features may help the pathologist to arrive at the appropriate diagnosis and reduce false interpretation. Pitfalls may also occur with improper technique of FNAC which can be overcome by proper caution.

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Transvaginal Ultrasonography and Saline Infusion Sonography Compared to Hysteroscopy for Diagnosis of Intracavity Lesion: A 4-Year Experience in Suburban Referral Hospital

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2020.06.10240 ◽

2020 ◽

Vol 103 (6) ◽

pp. 585-593

Keyword(s):

Predictive Value ◽

Final Diagnosis ◽

Saline Infusion ◽

Transvaginal Ultrasonography ◽

Histopathological Diagnosis ◽

Endometrial Polyps ◽

Saline Infusion Sonography ◽

Submucous Myoma ◽

Kappa Value ◽

Sensitivity Specificity

Objective: To evaluate the accuracy of transvaginal ultrasonography (TVS) and saline infusion sonography (SIS) in use for the diagnosis of endometrial polyps and submucous myoma compared to hysteroscopy. Histopathology was considered as the gold standard for final diagnosis. Materials and Methods: The present retrospective study was conducted at Bhumibol Adulyadej Hospital, Bangkok, Thailand between January 2014 and December 2017. Medical records of 150 patients who attended for hysteroscopy and histopathological diagnosis were reviewed. The accuracy of TVS and SIS for the diagnosis of endometrial polyps and submucous myoma were determined. Results: Out of 150 enrolled cases, endometrial polyp was the most frequent hysteroscopic finding in participants of the present study (92/150). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of TVS, SIS, and hysteroscopy compared to pathologic reports for detection endometrial polyps were 71.7% versus 93.5% versus 97.8%, 38.5% versus 52.2% versus 68.2%, 80.5% versus 88.7% versus 92.8%, 27.8% versus 66.7% versus 88.2%, and 64.4% versus 85.2% versus 92.1%, respectively. The sensitivity, specificity, PPV, NPV, and accuracy of TVS, SIS, and hysteroscopy for detection of submucous myoma were 81.6% versus 92.1% versus 94.7%, 66.7% versus 86.9% versus 100%, 77.5% versus 92.1% versus 100%, 72.0% versus 86.9% versus 90.9%, and 75.4% versus 90.2% versus 96.6%, respectively. The kappa value from TVS, SIS, and hysteroscopy when the histopathologic reports were overall intrauterine abnormalities, endometrial polyps and submucous myoma were 0.45/0.43/0.72, 0.77/0.76/0.89, and 0.92/0.92/1.00, respectively. Conclusion: Sensitivity, specificity, PPV, NPV, accuracy, and kappa value of SIS for detecting endometrial polyps and submucous myoma were better than TVS. Keywords: Ultrasonography, Saline infusion sonography, Hysteroscopy, Accuracy

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Classification of Male Breast Lesions According to the IAC Yokohama System for Reporting Breast Cytopathology

Acta Cytologica ◽

10.1159/000512041 ◽

2020 ◽

pp. 1-8

Author(s):

Melissa Oosthuizen ◽

Rubina Razack ◽

Jenny Edge ◽

Pawel Tomasz Schubert

Keyword(s):

Predictive Value ◽

Best Practice ◽

Internal Audit ◽

Needle Aspiration ◽

Male Breast ◽

Histopathological Diagnosis ◽

Breast Lesions ◽

Risk Of Malignancy ◽

Sensitivity Specificity

Objective: This study aims to determine the diagnostic utility of the International Academy of Cytology (IAC) Yokohama System for reporting breast cytopathology in lesions of the male breast. Study Design: Fine-needle aspiration biopsy (FNAB) reports between 2015 and 2019 were retrospectively recategorized according to the 5-tiered IAC Yokohama Reporting System. Our database yielded a total of 1,532 FNAB reports from breast lesions, obtained from 1,350 male patients. The risk of malignancy (ROM) and diagnostic performance of FNAB were determined using follow-up histopathological diagnosis and/or clinical follow-up, where available, for each category. Results: The category distribution were as follows: inadequate, 40%; benign, 57%; atypical, 0.6%; suspicious for malignancy, 0.7%; and malignant, 1.6%. The ROM in each category was nondiagnostic, 11%; benign, 3%; atypical, 28%; suspicious for malignancy, 56%; and malignant, 100%. The sensitivity, specificity, positive predictive value, and negative predictive value were recorded as 63, 100, 100, and 84.6% respectively, when only malignant cases were considered as positive tests. Conclusion: This study validates the IAC Yokohama System for reporting male breast cytopathology. In accordance with the aim of the Yokohama System to establish best practice guidelines for reporting breast cytopathology, this comprehensive scheme facilitates comparisons between local and international institutions. The ROM acts as an internal audit for quality assurance within one’s own laboratory and provides guidance for clinical management. It highlights inefficiencies such as high inadequacy rates for category 1 and also features strengths with impressive specificity for categories 4 and 5.

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Diagnostic accuracy of Multiparametric MRI in detection of prostate cancer compared with histopathology obtained by MRI directed TRUS guided cognitive fusion biopsy are T2WI, DWI and DCE enough for Indian scenario

MedPulse International Journal of Radiology ◽

10.26611/10132013 ◽

2021 ◽

Vol 20 (1) ◽

pp. 10-12

Author(s):

Mallinath Biradar ◽

Keyword(s):

Prostate Cancer ◽

Diagnostic Accuracy ◽

Predictive Value ◽

Prostatic Cancer ◽

Tertiary Care ◽

Multiparametric Mri ◽

Care Hospital ◽

Cognitive Fusion ◽

Fusion Biopsy ◽

Indian Scenario

Background: The incidence of prostatic carcinoma is increasing worldwide. With its high resolution, ability to provide excellent tissue characterization and multiplanar imaging capabilities, multi-parametric magnetic resonance imaging (mpMRI) plays a crucial role in detection, local staging and follow-up of carcinoma prostate. It also helps guide targeted biopsies in initial biopsy negative patient. Objectives: Study diagnostic accuracy of mp-MRI and primarily that of the three MR sequences T2, DWI and DCE in detection of prostatic cancer by correlating them with histopathology and thus whether it is feasible for a short MRI of 3 sequences to be used on a large scale in Indian scenario. Materials and Methods: A prospective study was done at a tertiary care hospital between April 2017 to November 2018 in which 50 patients who presented with suspicion of prostate cancer were referred to radiology department for evaluation using MRI. MRIexamination was done using 3T Siemens Magnetom Verio. Followed by this MRI directed TRUS guided cognitive fusion biopsy was done from the prostate. Samples were sent for histopathology. Results: Out of 50 cases studied, 24 cases (48%) were found to be malignant and 26 cases (52 %) were benign on histopathology. In our study, combined T2 + DWI + DCE gave sensitivity of 95.83 %, specificity of 57.69%, positive predictive value of 68.21 % and negative predictive value of 93.75%. Conclusion: Multiparametric MRI using T2, DWI and DCE has a high diagnostic accuracy for evaluation of prostatic cancer.

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Diagnostic Accuracy of Sonographic Septations in Tuberculous and Malignant Pleural Effusions

Journal of Islamabad Medical & Dental College ◽

10.35787/jimdc.v9i2.339 ◽

2020 ◽

Vol 9 (2) ◽

pp. 95-102

Author(s):

Abdul Rasheed Qureshi ◽

Muhammad Irfan ◽

Zeeshan Ashraf

Keyword(s):

Pleural Effusion ◽

Diagnostic Accuracy ◽

Predictive Value ◽

Tertiary Care ◽

Positive Likelihood Ratio ◽

Fisher Exact Test ◽

Care Hospital ◽

Pleural Effusions ◽

Malignant Pleural Effusions ◽

Malignant Group

Background: Discrimination between tuberculous (TB) and malignant pleural effusions is a real practical challenge because both exist as exudative lymphocytic type. Transthoracic ultrasonography not only identifies and quantifies pleural effusion but also displays sonographic septations, which are frequently seen in TB pleural effusions and can help in differentiation between tuberculosis and malignancy successfully, without any invasive procedure. We designed this study to determine the diagnostic usefulness of these septations for tuberculous and malignant pleural effusions. Material and Methods: This prospective study was conducted in the OPD of Gulab Devi Chest Hospital Lahore, Pakistan, a 1500 bedded tertiary care hospital, from November 2016 to February 2018. Total of 339 consecutive cases, aged 14-83 years with radiological evidence of pleural effusion were included in the study. After detailed history, thorough physical examination, radiological, haematological and biochemical findings were recorded. Pleural fluid macroscopic, cytological, microbiologic and biochemical analysis results were also recorded. Ultrasonography was done, septated and non-septated pleural effusions identified and findings were noted. SPSS-16 was used for statistical evaluation. Fisher Exact test was utilized for comparison between TB and malignant cases with P-value < 0.05 taken as significant. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy and positive likelihood ratio were calculated. Results: Out of total 339 cases, 49 (14.45%) were malignant and 290 (85.55%) were non-malignant. In the malignant group, only 03 cases (6.12%) showed sonographic septations. In the non-malignant group, 259/290 (89.31%) cases showed tuberculous etiology and 187/259 (72.20%) of these cases displayed sonographic septations. By considering septations as predictor of TB, statistical analysis revealed a sensitivity of 79.23%, specificity of 92.85%, PPV of 98.42%, NPV of 44.31% and diagnostic accuracy of 81.29%, respectively. Conclusions: Sonographic septations can be a valuable predictor of tuberculosis, in a population with high prevalence of the disease. We found it to be a useful feature in differentiating between a malignant and tuberculous etiology, in exudative lymphocytic pleural effusions. It can be used with confidence in patients who are unfit for interventional procedures.

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Nasomaxillary swellings: our experience at tertiary care hospital

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20210680 ◽

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

Background: 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.Methods: 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.Results: 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.Conclusions: 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.

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