Accuracy of fine needle aspiration cytology and thyroid imaging reporting and data system to predict the nature of nodular goiter and its comparison with postoperative histology

Background: Aim of the study was to find accuracy of pre-operative fine needle aspiration cytology (FNAC) and thyroid imaging reporting and data system (TIRADS) in predicting the nature of nodular goitre and confirming it with post-operative biopsy. Objective of the study was to assess the sensitivity and specificity of FNAC compared with post-operative biopsy and to assess the sensitivity and specificity of TIRADS compared with post-operative biopsy.Methods: This retrospective study was carried out at tertiary hospital, King George Hospital, Visakhapatnam over a period of 1 year from march 2018 to march 2019. Sensitivity and specificity are calculated based on formulae.Results: Sample size calculated with 90% confidence interval for population of vizag is 96, a sample of 100 patients were taken in this study. Of the 100 cases, 16 had thyroid carcinoma. 15 of them were papillary carcinoma and 1 follicular carcinoma. 8 cases matched with cytology report after post op biopsy and 8 we mismatched with cytology report after post op biopsy. The incidence of malignancy in clinically and cytologically benign goitre is 8.69. In our study sensitivity of FNAC is 50%, specificity is 100% and accuracy of test is 92% and TIRADS has a sensitivity of 100% and specificity of 72.62% and an accuracy of 77%.Conclusions: The current study has showed the disparity we see in thyroid neoplasms in FNAC test and TIRADS, which were proved to be different diagnosis in clinical and histopathology, so even if cytology is benign, we can’t rule out malignancy. FNAC and TIRADS combined have more sensitivity and specificity than individual tests.

A case report on expanding horizon of endobronchial ultrasound through esophagus

Endobronchial ultrasound has revolutionized the field of bronchoscopy and has become one of the most important tools for the diagnosis of intrathoracic lymphadenopathy and para-bronchial structures. The reach of this technique has not been limited to these structures and pleural lesions have been at times accessible. To our knowledge, pleural fluid collections have not been accessed with endobronchial ultrasound (EBUS) through oesophageal approach and rationale behind using this approach. We report a case of 70 years old man who has been referred from physician for the EBUS in view of hilar mass with mediastinal lymphadenopathy with pleural effusion. The endobronchial ultrasound through oesophagus (EUS-B) was done for thoracocentesis and lymph node cytology evaluation and ultimately endobronchial biopsy of hilar mass was done as rapid on-site (ROSE) analysis of lymph node was suggestive of necrotic tissue. The cytology report of lymph node and pleural effusion was positive for malignant cells. The final diagnosis was metastatic poorly differentiating adeno-squamous carcinoma.

Cytological Follow-Up of Cervical Intraepithelial Neoplasia 1 after Initial Management During 2-Year Period: Bhumibol Adulyadej Hospital Experience

Objective: To evaluate the frequency of cervical cytological results in patients diagnosed as low-grade squamous intraepithelial lesion (LSIL) in cytology report between women younger than 30 and woman 30 or older after initial management and the completed 2-year follow-up to suggest the proper management for Thai women. Materials and Methods: The present study was retrospectively conducted at Bhumibol Adulyadej Hospital, Bangkok, Thailand between January 2011 and December 2016. The medical records of 279 patients whose cervical cytology reported LSIL were reviewed. The prevalence of silent high grade cervical intraepithelial neoplasia (CIN 2/3) in LSIL cytology result was determined. The results of the cervical cytology after the patients completed the 2-year follow-up were evaluated. Results: During the present study period, 279 cases of LSIL in cytology result were enrolled. In women with LSIL in the cytology report, two-third were in pre-menopausal status. The prevalence of CIN 2/3 in LSIL cytology in women younger than 30 and 30 or older were 11.9% and 11.2%, respectively. At 2-year follow-up, around 97% of the patients who completed the follow-up had a spontaneous regression of the disease in both aged groups. Three percent of cases (3/85) had persistent disease in women 30 or older only. There was no progressive disease in the present study. Conclusion: Silent CIN 2/3 in LSIL cytology in the present study were high. Colposcopy should be recommended for diagnosis and follow-up in this setting. Abnormal Pap at 2-year follow-up was around three percent, therefore, abnormal cytology was still a problem. Continuous close cytology follow-up is still recommended. Keywords: Low-grade squamous intraepithelial lesion, LSIL, Cervical intraepithelial neoplasia, CIN, Cytology

Prostatic Ductal Adenocarcinoma with Papillary Features in a Bladder Washing: A Possible Pitfall in Urinary Cytology – Report of One Case

In this article, we report on a case of combined, acinar and ductal prostatic adenocarcinoma affecting the prostatic urethra, which, due to a low degree of cytologic atypia and an exclusive papillary architecture with visible fibrovascular core, was erroneously diagnosed as a low-grade urothelial carcinoma based on its peculiar cytologic presentation in a bladder washing sample.

Carcinoma of breast with medullary features: a case report in 27 year old female

Medullary carcinoma of breast is a rare variant of invasive ductal carcinoma of breast and its incidence is less than 5% of invasive breast carcinomas. These tumours tend to occur in younger women, with the average age reported to range from 42 to 52 years. Authors are presenting this case in a 27 years old female having single, large, well circumscribed mass in right breast for 6 months. Fine needle aspiration cytology report was proliferative lesion with atypia Histopathology report was given as carcinoma with medullary features. Immunohistochemistry showed Estrogen Receptor (ER), Progesterone Receptor (PR) and Her-2 neu negative. Authors are presenting this case of Medullary carcinoma of breast for being a specific histopathological subtype.

Intramuscular Sinusoidal Hemangioma with Masson’s Lesion, Masquerading as Parotid Tumor

Introduction Sinusoidal hemangioma is a rare variant of cavernous hemangioma, described first by Calonje and Fletcher, more frequently subcutaneous and commonly found on the extremities. Fine needle aspiration cytology report was indeterminate. In such cases preoperative diagnosis is difficult. Slowly growing mass is the usual presenting complaint. Case Report A rare case of intramuscular sinusoidal hemangioma, with typical Masson’s lesion masquerading as a parotid tumor, in middle aged woman. Discussion Hemangiomas comprise 7% of all benign tumors and they are benign proliferative vascular tumors characterized by increased endothelial cell turn over. They are usually superficial and easy to diagnose whereas intramuscular hemangiomas (IMH) are uncommon and deep seated and difficult to diagnose. Fifteen percent of the IMHs are found in the head and neck area and the most common muscle affected is the masseter.