Syed Fiza Mustaqueem

Abstract

Background: The proportion of cancers of genital tract origin in females ranges from 22.4% to 55.8% in India; thus posing a major health problem. The first step in controlling the cancer burden in any population is to collect information about its salient features in that particular cohort of patients. This study was performed to ascertain the profile of female genital tract malignancies reported at our center regarding the relative frequency of involvement of various sites, age and symptoms at presentation and histological subtypes. Materials and Methods: All the confirmed cases of female genital tract malignancies received in the Department of Pathology were studied for a period of 2 years from November 2008 to October 2010. Result: A total of 175 cases were reported. The anatomic distributions were: cervix 123 (70.3%), uterus 11 (6.3%), ovary 30 (17.1%), vagina 4 (2.3%), vulva 5 (2.9%) and fallopian tube 2 (1.1%). The mean ages of women diagnosed with these cancers were: cervix (51.1 years), uterus (54.5 years), ovary (46.5 years), vagina (57 years), vulva (54.5 years) and fallopian tube (49.5 years). Women with cervical and uterine malignancies presented commonly with bleeding per vaginum; while those with ovarian malignancies presented mostly with abdominal mass. Women with vaginal and vulval malignancy presented with ulcers and masses. The most common histological subtypes at different sites were; Cervix: Squamous cell carcinoma (SCC) (87%); Uterus: Endometrioid adenocarcinoma (81.8%); Ovary: Serous cystadenocarcinoma (53.3%); Vagina: SCC (75%); Vulva: SCC (60%) and Fallopian tube (50% adenocarcinoma and 50 % metastatic carcinoma). Conclusion: As female genital tract malignancies form a huge burden of morbidity and mortality in India, there is a need to establish better screening programmes aimed at early detection and educate the public regarding the risk factors as well as early symptoms of the disease so that people can adapt appropriate behaviour.   Keywords : Female genital tract malignancies, Morbidity, Histological subtypes, Northern India

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Abstract

Introduction: Peripheral lymphadenopathy is frequently due to a local or systemic benign infectious disease. However, it could be a manifestation of underlying malignancy. Fine needle aspiration cytology (FNAC) acting as a reliable diagnostic tool to find out the cause underlying the lymphadenopathy enables the clinician to plan appropriate management for each patient. Objective: The present study was undertaken to assess the utility of FNAC in evaluation of peripheral lymphadenopathy cases in different age groups and sex and to study the cytomorphological patterns in these cases. Materials and Methods: A retrospective and prospective observational study was conducted in the Department of Pathology, Hind Institute of Medical Sciences over the duration of 2 years. A total of 331 lymph node FNA aspirates were studied. Aspirated material was routinely stained with Haematoxylin & Eosin and Papanicolauo stains. Ziehl Neelsen stain was used wherever required. Results: Most of the patients were in the age group of ?15 years (117/331). Cervical lymphnodes were the most commonly involved sites (222/331). The largest group of lesions belonged to the non-neoplastic category (227/331). Only 54/331 cases were in the neoplastic category. Amongst the non-neoplastic lesions, granulomatous lymphadenitis comprised the majority (128/277). Amongst the neoplastic lesions, 8 cases showed features of non-Hodgkin’s lymphoma (NHL); where as 3 cases were of Hodgkin’s lymphoma (HL). Non-neoplastic lesions were more common in the younger age group (117/257); where as neoplastic lesions were more common in the older age group (27/54). Conclusion: FNAC is a reliable method of diagnosing the pathology underlying enlarged superficial lymph nodes; thus acting as a triage to distinguish the cases with a suspicion of significant disease. At the same time, it also provides material for ancillary studies especially in lymphoproliferative lesions.   Keywords: FNAC, Cytomorphology, Peripheral lymphadenopathy

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