Surbhi Dahiya

Abstract

Histoplasmosis is a non – contagious systemic infection which is caused by a dimorphic fungal organism, Histoplasma capsulatum. In India, West Bengal accounts for the maximum number of cases of histoplasmosis followed by Uttar Pradesh and Delhi. 99%, are restricted to the lungs and are self limiting infections. It mostly affects the immunocompromised patients but may affect the immunocompetent individuals as well.We hereby report a series of 4 cases of Histoplasmosis both in immunocompetent and immunocompromised patients on Fine needle aspiration cytology using May Grunwald Giemsa, Gomori Methenamine Silver and Periodic Acid Schiff stains.Disseminated histoplasmosis,if not treated can be fatal,therefore it is important to timely diagnose it and treat with adequate antifungal drugs. FNAC of lesions along with special stains, can be a promising modality for establishing a rapid diagnosis of histoplasmosis and thereby planning early treatment of the disease. Keywords: Fungal stains, Histoplasmosis.

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Abstract

Introduction: The primary objective of evaluation of the thyroid lesions by FNAC is to distinguish the majority of benign from malignant lesions. To standardize the reporting system for thyroid FNA, NCI hosted a multidisciplinary Thyroid State of the Science Conference in Bethesda, in October 2007, providing a uniform and pertinent reporting nomenclature. Aim and Objectives: To assess the effectiveness of FNAC by using Bethesda system of reporting in the evaluation of thyroid lesions. Materials and Methods: This study included smears from all thyroid FNACs performed over a period of 6 months. FNA smears were reported according to the 6 diagnostic categories of TBSRTC. We could pursue follow up histology for 24 cases. The diagnosis offered in FNAC was compared with that observed on histopathology. Results: We received 87 cases, out of which 9 were males and 78 were females with male to female ratio of 1:8.6. Benign lesions constituted 74.7% and malignant lesions 4.6%. Bethesda category I included 4.6% cases, category II 74.7% cases, category III 3.4% cases, category IV 10.3% cases, category V 2.3% cases and category VI 4.6% cases. Category I had no follow up cases, so the rate of malignancy could not be assigned. On histopathological examination, the rate of malignancy of category II was 6.6%, category III 50%, category IV 66.6%, category V 100% and category VI 100%. Conclusion: The Bethesda System is a very useful and reproducible system of reporting thyroid cytopathology and also guides the clinicians for consistent management approach thereby preserving the credibility of reporting. Keywords: Bethesda reporting, Colloid goiter, Thyroid FNAC.

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