Gourik Gangopadhyay

Abstract

Diabetes mellitus is a public health problem significantly contributing to morbidity and mortality worldwide. The patients are highly prone to opportunistic infections with major systemic as well as cutaneous fungi. The fungal infections frequent in diabetics include Candidiasis as well as cutaneous Aspergillosis. The most commonly involved species include Aspergillus niger, Aspergillus flavus and Aspergillus fumigatus. Presenting here is a case of 60 years male with history of diabetes mellitus type 2 on oral hypoglycaemic agents, presenting in Medicine Out Patient Department with complaints of progressive painless left cystic medial ankle swelling for last 4 months. Patient was then asked to undergo FNAC which revealed pyogenic inflammation with giant cells and fungal hyphae showing acute angled branching. Furthermore, microbiological confirmation was also done and patient was initiated treatment for the same. This case report underlines the importance of FNAC and Cytological study in the accurate and early diagnosis of Cutaneous Aspergillosis even before the more expensive and time-consuming microbiological diagnostic modalities are applied.   Keywords: Cutaneous aspergillosis, Diabetics, FNAC

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Abstract

Introduction: Sputum Cytology is a cheap and noninvasive investigation contributing significantly to the workload of Cytopathology Laboratories. However, over the years, the use of Sputum Cytology has depreciated. It has been taken over by more advanced procedures like Broncho Alveolar Lavage and Trans Bronchial Needle Aspiration, which are comparatively invasive and expensive requiring a much higher learning curve. Hence, the usefulness of noninvasive samples like Sputum needs to be explored in resource limited settings. Purpose: To study the spectrum of Lung lesions diagnosed using Sputum Cytology with Histopathological correlation wherever possible. Materials and Methods : This was a three years retrospective study. Data of patients who had come with sputum sample was retrieved from the archives of the cytopathology lab between July 2019 and June 2022. Cytology findings were correlated with histopathological diagnosis, wherever possible. Results: Out of the total sample size of 143, 67 showed inflammatory infiltrate, 1 out of which was confirmed to be malignant on biopsy. 17 cases were suspected to be malignant, out of which 15 were confirmed on biopsy. Other samples revealed the presence of fungal infection, dysplasia with no frank malignancy and reactive changes. Conclusion: Our study shows that sputum testing can be quite an accurate method in the early diagnosis of many lung lesions including malignancies. The Sensitivity and Specificity for malignancy was 83.33% and 95% respectively. Therefore, it can be applied as a cheaper, noninvasive ideal screening test for the early detection of lung pathologies especially in resource poor settings.   Keywords: Cytopathology, Dysplasia, Malignant, Noninvasive, Sensitivity, Sputum

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