Zeenath Begum

Abstract

Introduction: Fine needle aspiration cytology (FNAC) is a safe, cost effective and accurate means of evaluating thyroid lesions. Using The Bethesda system of reporting thyroid cytopathology (TBSRTC), cytopathologist can communicate thyroid FNA interpretations to the referring physician which is clinically useful. Aim: To describe the cytomorphological features of FNAC and correlate with thyroid hormone status in patients presented with diffuse swelling/solitary nodule of thyroid. Materials and Methods: A total of 50 cases of thyroid FNA s studied for 10 months duration from Dec 2019 to Sept 2020 in the Department of pathology, KBNIMS, Gulbarga. The lesions were evaluated cytologically, categorised according to the Bethesda system for reporting thyroid cytopathology and correlated with Thyroid hormone profile. Results: Out of 50 cases of thyroid FNAs studied, Females were most commonly affected and most common age group affected was middle aged individuals (31-40yrs). Bethesda Category 2 benign lesions were most commonly present in our study. Benign follicular nodule was more common among non neoplastic lesions. Most of the benign and malignant lesions were euthyroid and hypothyroidism is seen in hashimoto thyroiditis in most cases. Conclusion: FNAC is a simple and cost effective diagnostic modality for thyroid lesions with high specificity and accuracy. cytological analysis in conjunction with thyroid hormone profile, helps clinicians determine the course of therapy in effective management of patients with thyroid lesions. Keywords: Bethesda category, FNAC, Thyroid lesions, T3, T4, TSH.

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Introduction: The head and neck area is a complex anatomical structure which includes various nonneoplastic and neoplastic lesions of lymph node, salivary gland, thyroid gland and soft tissue. Fine needle aspiration cytology of head and neck lymph nodes proved useful in separating inflammatory lesions, which do not require surgical excision from cystic and neoplastic lesions with good certainty. Fine needle aspiration cytology (FNAC) is a simple, feasible, cost effective and minimally invasive procedure. But histopathological examination is more valuable for confirmatory diagnosis in suspected lesions. Aim: To assess the utility of FNAC in diagnosis of head and neck lymph node lesions and to establish the diagnostic accuracy of cytology by comparing with the histopathological diagnosis, wherever possible.  Materials and Methods: A 6 months retrospective study was done from March 2020 to August 2020 at Khaja Bandanawaz institute of medical sciences on 50 patients presenting with head and neck lymph node enlargement. Result: 50 cases were evaluated by FNAC. In this study out of 34 benign cases, 14 cases were of Reactive lymphadenitis, 17 cases of Granulomatous/Tuberculous lymphadenitis and 3 cases were of Acute suppurative lymphadenitis. Out of 16 malignant cases, 5 cases were of Non Hodgkins lymphoma, 2 cases were of hodgkins lymphoma and 9 cases were of metastatic carcinoma. Conclusion: FNAC has been found to be a satisfactory tool in the diagnosis of tubercular and malignant lymphadenopathy in our study. The lucidity and rapidity of the procedure makes it most appropriate for use on outpatient basis even in peripheral hospitals and dispensaries. Keywords: FNAC, Head and neck, Lymphadenopathy, Tuberculous lymphadenitis.

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Abstract

Introduction: Breast cancer is a commonest maliganancy of women globally. A papable breast lump is common diagnostic dilemma to surgeons. Fine needle aspiration cytology (FNAC) is simple rapid, accurate diagnostic tool for evaluating palpable breast lumps. Mammography is other screening modality for a breast lump which is routinely used method with simple, low cost with high accuracy. Aim: To differentiate and categories the breast lesions, and to study the correlation of FNAC with histopathology of palpable breast lumps. Materials and Methods: one and half year retrospective study carried out from January 2019 to June 2020 in the department of pathology, KBNIMS, Gulbarga. FNAC and Histopathology slides were retrieved and reviewed. All the slides were observed and findings recorded. Mammography findings were retrieved and recorded. Result: The present study includes 125 cases out of which 101 cases (80.8%) were benign and 24 cases (19.2%) were malignant. Most common benign breast lesion was fibroadenoma (52.4%) and malignant lesion was infiltrating ductal carcinoma (75%). Frequencies of left breast lesions were high compare to right breast lesions. Out of 125 cases FNAC, 123 cases (98.4%) correlated with histopathology with sensitivity of 91.66%, specificity of 100%, positive predictive value (PPV) of 100%, negative predictive value (NPV) of 98% and accuracy of 98.4%.Out of 125 cases, mammography of 25 cases were retrieved with sensitivity of 87.5% and specificity of 94.11% with diagnostic accuracy of 92%. Conclusion: FNAC is a valuable diagnostic tool; provide rapid and reliable diagnosis in breast lesions. Keywords: FNAC, Benign breast lesions, Malignant breast lesion, Histopathology.

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