GVRN Krishna Kanth

Abstract

Introduction: Breast malignancies are one of the commonest malignancies in Indian women. Increasing urbanization is attributed to raise of breast cancers and have surpassed cervix cancer in recent times and are now ranked top in some metros. FNA is used as an important diagnostic tool as a part of triple assessment. The application of the IAC Yokohama system in breast cytology improves the reporting and also allows the calculation of risk of malignancy (ROM). Aim: The main aim of the study is to; 1. Apply the IAC Yokohama system for the diagnostic; 2. assessment and subsequent categorization of FNA samples and correlate them with histopathology examination (HPE); 3. calculate ROM; 4. Calculate p-value. Materials and Methods: A total of 305 samples received were diagnosed and classified according to the IAC Yokohama system. The study was conducted over a period of 2 yrs retrospectively from June 2019 to May 2021. For the 305 FNA samples received, HPE correlation was made and statistical parameters, ROM , p-value were calculated. Results: 305 FNA samples were obtained and categorized according to the IAC Yokohama system. They were categorized and the percentage of incidence noted as 1. Insufficient - 6.89%, 2.Benign - 72.46%, 3.Atypical probably benign - 3.28%, 4. Suspicious - 3.28%, 5. Malignant - 14.09%. ROM was also calculated. The distribution of cases in percentage as per categories are: category 1 – 0%, category 2 - 2%, category 3 – 0%, category 4- , 42.86% category 5- 100%. For 305 FNA samples reported 95 cases received for HPE and subsequently cyto – histopathological correlation was made and statistical parameters were calculated. Compiled statistics showed sensitivity of 100%, specificity of 93.54%, NPV of 100%, PPV of 89.19% and diagnostic accuracy at 95.78%. The p-value for the present study is 0.0001 which is very significant. Conclusion: Application of the IAC Yokohama system of reporting breast cytopathology helps in better categorization of FNA samples and it improves the efficacy of cytopathologist. It gives better clarity to the clinicians in the management of the patient and can reduce unnecessary surgeries.   Keywords: IAC Yokohama, Breast FNA, Histopathological correlation, Risk of Malignancy, p-value

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Abstract

Introduction: Rapid advances have taken place in the classification of papillary thyroid neoplasms with reclassification and addition of new variants. One such change is the addition of a new entity called NIFTP (Non-invasive Follicular Thyroid Neoplasm with Papillary like nuclear features). So called recognising its non-malignant potential. Study Design: The present study is a retrospective observational cohort study on thyroidectomy specimens collected between Jan 2018 to June 2021 focussing on variants of papillary carcinoma with special emphasis on recognising NIFTP – which has got good prognosis and is considered non-malignant. Results: Out of the 40 cases of papillary neoplasms 36 were PTC and 4 were NIFTP. Among the PTC cases 27 were classic PTC, 4 were FVPTC (Follicular Variant of Papillary Thyroid Carcinoma) 3 were papillary microcarcinoma, 1 was Warthin like Variant of PTC and 1 was Encapsulated PTC. Conclusion: The Study concludes that special vigilance is required in strictly adhering to the criteria proposed by new 2017 WHO classification of Papillary tumours. Recognising NIFTP as it is a nonmalignant entity should be given due importance. Keywords: Papillary Thyroid Carcinoma (PTC), Risk stratification, Variants of PTC, Non­invasive follicular

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