Prajna Das

Abstract

Introduction: Lung cancer is one of the most common causes of cancer related mortality. Various methods for cytological diagnosis like fine needle aspiration (FNA) along with exfoliative cytology by bronchial brushings play a pivotal role in the diagnosis as well as categorization of Non small cell lung carcinoma (NSCLC); especially in advanced stages and cases where biopsy may not be feasible. Aims & Objectives: The aim of the study was diagnosis and subclassification of Non small cell lung carcinoma (NSCLC) from cytosmears of bronchial brushings and Fine needle aspiration cytology (FNAC) samples followed by histopathological and clinicopathological correlation. Materials and Methods: The present study is both prospective & retrospective study done in Department of Pathology for a period of 2 years (September 2018- September 2020). A total of 46 cases were included in the study group. Categorization of lung cancer was done based upon the 2015World Health Organization (WHO) criteria of cytodiagnosis. Histological correlation was done wherever available. Correlation with clinicopathological parameters was also done. Results: Total 46 patients were included in the study. The age range of was 32-81 years with a mean age of 59.2years. Male to female ratio was 2. 06:1. Smokers were affected in 26 cases (56.52%). The incidence of Adenocarcinoma (ADC) was commonest in our study comprising of 15 cases (32.61%). This was followed by squamous cell carcinoma (SCC) in 11 cases (23.91%), NSCLC-favours ADC in 8 cases (17.39%), NSCLC-NOS in 4 cases (8.70%), suspicious of malignancy in 3 cases (6.52%) and 2 cases (4.35%) each of NSCLC favours SCC & atypical and one case (2.17%) of ADC-lepidic pattern. Cytohistological correlation was possible in 25 core biopsy cases with 68% concordance. Conclusion: Cytological techniques are safer, economical and provide quick results. But a comprehensive clinicopathological approach is needed for labelling a correct diagnosis. Keywords: ADC, Cytology, FNAC, NSCLC, SCC, WHO.

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Abstract

Introduction: Salivary gland lesions show cytomorphological heterogeneity with many overlapping features. FNAC is a common preliminary diagnostic tool for evaluation of the lesions of salivary glands. The main goal of FNAC is for proper initial diagnosis and its further management. Hypothesis: This was a prospective study conducted over a period of two years from January 2018 to January 2020. Total 120 patients having salivary gland swellings were included the study. The lesions were initially assessed by FNAC and subsequently correlated with histopathology wherever possible. Results: Middle aged females (40-50yrs) were the common cases in the present study with parotid swelling the most common site. Chronic sialadenitis was the most common non-neoplastic lesion. Pleomorphic adenoma was the most common benign and mucoepidermoid carcinoma was the most common malignant neoplasm. The sensitivity, specificity, positive predictive value PPV) and negative predictive values (NPV) of FNAC in our study were 77.8%, 98.11%, 87.5 % and 96.3% respectively with a diagnostic accuracy of 95%. Conclusion: FNAC is an excellent preliminary diagnostic technique for planning the management of salivary gland lesions. However, due to overlapping cytological features and heterogeneity it should always be correlated with clinical and radiological findings along with histopathology for a definitive diagnosis. Keywords: Salivary gland, Parotid, FNAC, PPV, NPV.

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Abstract

Introduction: Hypothyroidism during reproductive age group is responsible for menstrual irregularities, infertility along with miscarriages and congenital malformation s during pregnancy. It has a prevalence of 5-20% in child bearing age. Autoimmune thyroiditis is the common cause of subclinical hypothyroidism in adult female population. Presence of thyroid autoantibodies is high in subclinical hypothyroidism. American Thyroid Association (ATA) & American Association of Clinical Endocrinologist (AACE) recommends for treatment of these patients. Lack of obvious signs and symptoms in subclinical hypothyroidism creates dilemma and challenge for diagnosis. Hypothesis: This was a retrospective study conducted in Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar during the period from January 2017 to January 2019. Women of reproductive age group having thyroid swellings were subjected to Fine needle aspiration cytology (FNAC), Thyroid function test and Anti TPO Ab levels in serum. Cytological grading was done and it was correlated with clinical presentation and serological parameters. Results: Out of 120 cases, 56.7% patients were hypothyroid. Increased titre of Anti- TPO Ab levels in serum was observed in 91.4%, 95.3% and 95% cases of Grade I, Grade II & Grade III categories of autoimmune thyroiditis respectively. Conclusion: Autoimmune thyroiditis is the common cause of hypothyroidism in adult females. Early detection and management with low dose of thyroxine will prevent the complications during reproductive period. Keywords: Autoimmune thyroiditis, Hypothyroidism, Anti-TPO Antibody, TFT.

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