Dayal Singh Bisht

Abstract

Astrocytomas are the most common primary brain tumor with prognosis highly dependent on Grading of the tumor. With the limited tissue available in stereotactic biopsy and often not representing the area of concern, development of new antibodies targeted against specific proteins in mitotically active cells is necessary. Ki67/MIB-1 LI has conventionally been used along with mitotic count to grade the astrocytomas. However Ki67 has limitation that it is expressed by cells through the cell cycle and it is difficult to differentiate mitotically active cells from apoptotic cells. In this study, thirty cases of various grades of astrocytomas were labelled with antibodies against Mitosin and PHH3 along with Ki67/MIB-1 and Mitosin Index and PHH3 Index were compared with Mitotic Index and MIB-1 LI. The present study depicted statistically significant difference of Mitosin Index and PHH3 Index amongst most of the grades of astrocytomas. Also it indicated a positive correlation amongst all four markers of proliferative index, the strongest being between PHH3 and Mitosin. Immunohistochemical determination of proliferative activity in astrocytomas using antibodies against PHH3 and Mitosin may assist in the histopathological diagnosis. Keywords: Tumors astrocytoma ki67 PHH3, mitosin Labelling index mitotic index.

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Abstract

Background: A prospective observational study was conducted in a zonal care hospital probing the role of FNAC in palpable head and neck lesions & its diagnostic utility which can differentiate the various neoplastic and non neoplastic lesions of head and neck very cost effectively. Aims and Objectives: To study diagnostic utility of fine needle aspiration cytology(FNAC) in head and neck lesions. Materials and Methods: A one year prospective observational study carried out at a zonal care hospital, which included a total of 120 patients reported with head and neck masses in the Otorinolaryngology OPD. Observations and Results: Out of 120 FNACs, 38 (31.66%) cases were of thyroid origin, 35 (29.16%) cases included cervical lymph nodes, 34 cases (28.33%) arised from soft tissue and 04 (3.33%) from salivary glands. Thyroid lesion involvement (31.66%) was more common than any other lesion, out of which 84.21% were colloid goitre, 7.89% were Hashimoto’s thyroditis, 5.26% follicular neoplasm and 2.56% papillary carcinoma of thyroid. Amongst the lymph node swellings, 13 cases (36.11%) were reactive/ nonspecific lesion, 12 cases (33.33%) were tuberculous granulomatous lymphadenitis, 16.66% were cases of suppurative lymphadenitis. In malignant lesions of lymph nodes, metastatic deposit of carcinoma and poorly differentiated carcinoma were the predominant pathology and lymphoma case was nil. Conclusion: FNAC of head and neck swelling is a worldwide accepted diagnostic modality. It is simple, inexpensive and rapid method for the diagnosis of head and neck lesion and avoids unnecessary surgery in the form of excision biopsy for diagnosis.   Keywords: Fine needle aspiration cytology, Head and neck swellings, Papillary carcinoma of thyroid, metastatic neck lesions, Poorly differentiated carcinoma, Tubercular lymphadenitis, Salivary gland neoplasm.

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