Fine Needle Aspiration Cytology Analysis of Breast Lumps: A Histopathological Correlation Study | Chapter 4 | Medical Science: Updates and Prospects Vol. 7

 

Background: Since the introduction of fine needle aspiration cytology (FNAC), the diagnostic approach to palpable breast lumps has been significantly improved. FNAC is a minimally invasive, rapid, and cost-effective technique with high sensitivity and specificity, and it remains an integral component of triple assessment for breast lesion diagnosis.

 

Objective: This study aims to analyse the cytological spectrum of palpable breast lumps diagnosed by FNAC and to evaluate its diagnostic accuracy in differentiating benign and malignant breast lesions through histopathological correlation.

 

Materials and Methods: A two-year prospective study was conducted at our institution, during which 490 FNAC procedures (including six bilateral cases) were performed on patients presenting with palpable breast lumps. Suppurative and inflammatory lesions were excluded. Cytological diagnoses were categorized as benign, suspicious and malignant. Among these cases, 94 patients subsequently underwent mastectomy or open/excision biopsy, and FNAC findings were correlated with histopathological diagnoses. Diagnostic performance parameters of FNAC were calculated using histopathology as the gold standard.

 

Results: Of the 490 FNAC cases, 373 were reported as benign, 4 as suspicious for carcinoma, and 113 as carcinoma. The majority of patients were premenopausal women, with the most common age group being 31–40 years. Histopathological follow-up was available in 94 cases. FNAC demonstrated an accuracy of 100% for benign lesions and 92.10% for malignant lesions, with a false-negative rate of 7.90% and no false-positive results. The overall sensitivity, specificity, positive predictive value, and negative predictive value of FNAC in diagnosing palpable breast lumps were 92.10%, 100%, 100%, and 94.91%, respectively.

 

Conclusion: FNAC, when performed by experienced hands, is a highly reliable diagnostic tool for palpable breast lumps, characterised by very high specificity and an extremely low false-positive rate. Its sensitivity can be further enhanced through appropriate clinical and imaging correlation. Despite evolving diagnostic modalities, FNAC continues to play a vital role in the systematic evaluation and management of breast lumps, particularly within a multidisciplinary diagnostic framework.

 

 

Author(s) Details

S. Akte
Department of Pathology, North Bengal Medical College, Sirajganj, Bangladesh.

 

M. J. Islam
Department of Surgery, Shaheed M. Monsur Ali Medical College, Sirajganj, Bangladesh.

 

M. S. Haque
Department of Nephrology, Shaheed M. Monsur Ali Medical College, Sirajganj, Bangladesh.

 

Please see the book here :- https://doi.org/10.9734/bpi/msup/v7/7226

Fine Needle Aspiration Cytology for Early Detection of Cutaneous Metastases: Insights from a Tertiary Care Center | Chapter 13 | Medicine and Medical Research: New Perspectives Vol. 7

 

Introduction: Skin metastasis can be the presenting symptom of many malignant tumors. These signs occur a long time before the diagnosis of the primary tumors or their recurrence and sometimes after surgery. These initial cutaneous tumors may aid in the diagnosis of primary tumors.

 

Aim: This study was conducted to identify them and to establish the utility of Fine Needle Aspiration Cytology (FNAC) to diagnose these lesions. As FNAC is a simple, rapid, cost-effective, minimally invasive OPD procedure. No anesthesia or special equipment is needed and it can be practised in a small setup.

 

Materials and Methods: The study was conducted in a tertiary care center. Clinical history, presenting features, and FNAC findings of the cutaneous lesions were noted. Immunocytochemistry(ICC) and Immunohistochemistry (IHC) from cell block were done when necessary. These findings then corroborated with Histopathological diagnosis.

 

Results: This study includes the cases of cutaneous metastatic deposits from various primary visceral malignancies, Lung, Gastrointestinal tract, thyroid, ovary etc. at different sites. The sites of cutaneous metastasis are the chest wall, scalp, and anterior abdominal wall, all over the body. The patients underwent preliminary investigations and FNAC. After a diagnosis of neoplastic lesions, the patients were referred to the Radiology, surgery, and radiotherapy department for further management.

 

Conclusion: Metastatic skin lesions may develop due to lymphatic and blood spread. It may be the first presenting feature of the malignant tumor or its recurrence. This study also proves the efficacy of FNAC in ascertaining the nature of these lesions. The cytological features along with clinical findings and radiological imaging help the early recognition of the primary lesion or identification of recurrence and thus help the clinicians in planning appropriate management.

 

Author (s) Details

 

Madhumita Mukhopadhyay
Department of Pathology, IPGME&R, Kolkata, West Bengal, India and JISMSR, West Bengal, India.

 

Ananya Ghatak
Department of Pathology, IPGME&R, Kolkata, West Bengal, India.

 

Chhanda Das
Department of Pathology, NRSMCH, Kolkata, India.

 

Subhamoy Saha
Department of Pathology, IPGME&R, Kolkata, West Bengal, India.

 

Binata Bandopadhyay
Department of Pathology, Murshidabad Medical College, Berhampore, West Bengal, India.

 

Malabika Baisya
Department of Pathology, IPGME&R, Kolkata, West Bengal, India.

 

Rituparna Kayal
Department of Pathology, IPGME&R, Kolkata, West Bengal, India.

 

Biswanath Mukhopadhyay
Department of Pediatric Surgery, Apollo Multispeciality Hospital, Kolkata, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/mmrnp/v7/2345

Determining the Spectrum of Pathologies on FNAC Evaluation of Peripheral Lymph Nodes at a Tertiary Care Center in Hyderabad, India | Chapter 3 | Advanced Concepts in Medicine and Medical Research Vol. 4

 Fine Needle Aspiration Cytology (FNAC) is an main diagnostic procedure secondhand for rapid judgment of a multitude of lesions. One of the common uses is for disease of the underlying study of plants of enlarged lymph nodes. The study's aim was to examine the pattern of diseases seen on Fine annoy aspiration (FNA) of increased superficial lymph nodes in a after second hospital in Hyderabad from January 2014 to August 2016, as well as to decide the patient profile the one underwent this surgery at our emergency room.To ascertain the age and sexuality distribution of the patients in addition to the distribution of pathologies recognized on FNA evaluation of the lymph nodes, dossier pertaining to the victims who underwent FNA judgment of superficial lymph nodes from January 2014 to 31 August 2016 at a after second hospital situated in Hyderabad, Telangana, were analyzed.The majority of the cases who endured FNA evaluation of lymph nodes were women (61%; 156 out of 253 inmates). The bulk of the patients were betwixt the ages of 20 and 50. The most common disease in our dataset (49.8%; 126 instances out of 253 FNA examinations) was reactive lymph bud hyperplasia. The second most common disease (37.15%; 94 out of 253 FNA assessments) was granulomatous lymphadenitis.The ailment causing enlarged detail lymph nodes maybe accurately diagnosed by fine tease aspiration test, which is quick, natural, relatively non-frightening, and reliable in the hands of experts. The two most frequent causes of increased lymph nodes in our order were granulomatous lymphadenitis and reactive lymph node hyperplasia.

Author(s) Details:

Ramanan Duraiswami,
Department of Pathology, Mallareddy Institute of Medical Sciences, Suraram, Hyderabad-500055, Telangana, India.

Sujatha Margam,
Department of Pathology, Mallareddy Institute of Medical Sciences, Suraram, Hyderabad-500055, Telangana, India.

Priya Chandran,
Department of Pathology, Mallareddy Institute of Medical Sciences, Suraram, Hyderabad-500055, Telangana, India.

Akina Prakash,
Department of Pathology, Mallareddy Institute of Medical Sciences, Suraram, Hyderabad-500055, Telangana, India.

Please see the link here: https://stm.bookpi.org/ACMMR-V4/article/view/12472

Innovative Diagnostic Method Using Immunocytochemistry (Estrogen Receptor) for Diagnosis and Management of Breast Cancer | Chapter 15 | Current Progress in Medicine and Medical Research Vol. 9

This study proposed to evaluate the influence of Immunocytochemistry (ICC) on Fine Needle Aspiration Cytology (FNAC) using estrogen receptor (ER), in diagnosing conscience lesions, equating them to success standard Core Needle Biopsy with Immunohistochemistry (IHC). A total of 50 samples were composed and analyzed utilizing both FNAC and Core Needle Biopsy methods.For FNAC, the results demonstrated superior depiction: Sensitivity=100%, Specificity=100%, Diagnostic Accuracy=100%, Positive Predictive Value (PPV)=100%, and Negative Predictive Value (NPV)=100%.Similarly, the results for ICC using ER were too favorable: Sensitivity=100%, Accuracy=100%, Positive Predictive Value= 100% and Negative Predictive Value=100%.These verdicts suggest that ICC utilizing ER could be a part of a trustworthy alternative to the gold-standard demonstrative tests. This technique substantiates particularly valuable in positions where capability disadvantages prevent the use of the standard test. However, it is necessary to note that further studies with a best sample size are essential to generalize these results.Furthermore, this study complicated the utilization of theme dossier analysis on FNAC reports. The study revealed that nearly 11.35% of the dataset contained beneficial words, signifying that normalization processes can abridge the data and manage valuable for assisting dispassionate chart reviews and clinical resolution support systems.

Author(s) Details:

Rohith R. Nair,
J.S.S. Medical College, Mysore, Karnataka- 570015, India.

Sonali Nandish,
Department of Computer Science and Engineering, JSS Science and Technology University, Mysore, Karnataka - 570006, India.

R. J. Prathibha,
Department of Information Science and Engineering, JSS Science and Technology University, Mysore, Karnataka - 570006, India.

N. M. Nandini,
Department of Pathology, JSS Medical College and Hospital, Constituent of JSSAHER, Mysore, Karnataka - 570004, India.

Please see the link here: https://stm.bookpi.org/CPMMR-V9/article/view/11699

Determination of Robinson Cytological Grading of Invasive Ductal Carcinoma of Breast| Chapter 5 | Current Overview on Disease and Health Research Vol. 10

 Breast abnormal growth in animate being is the most ordinary cause of death in females everywhere, which concede possibility be detected early and acted promptly. In underdeveloped countries, breast carcinoma is still pinpointed using fine-tease aspiration plant structure (FNAC). Instead of simply reporting as favorable or malignant, we concede possibility focus on eliciting the most prognostic facts from cytological smears to help clinicians improve the effects of new chemotherapeutic powers on patient survival. Robinson and others. present a cytological grading order that closely parallels Elston's modification of Scarff Bloom Richardson's histologic grading design. This Retrospective study was done to judge the importance of cytologic evaluating of breast carcinoma and equate it with histological evaluating.The present study was done over a sample proportion of 35 patients for over a span of 12months. 35 Patients the one go through FNAC and mastectomy for carcinoma of conscience were cytologically and Histologically Graded. The results obtained by two together grading procedures were then compared.In the study all were female. On comparison of the cytological and histological grades, 100% cases were grade III, 81% cases were grade II , 72% were grade I two together on cytology and study of animal.The current study demonstrates that a natural cytological grading helps in evaluating the patient's forecast and provides various treatment alternatives depending on the grade.

Author(s) Details:

Jigna Prakashbhai Patel,
Department of Pathology, Smt BK Shah Medical Institute & Research Centre, Sumandeep Vidyapeeth an Institution deemed to be University, Piparia, 391760, Vadodara Gujarat, India.

Trupti Rajeshbhai Jansari,
Department of Pathology, Smt BK Shah Medical Institute & Research Centre, Sumandeep Vidyapeeth an Institution deemed to be University, Piparia, 391760, Vadodara Gujarat, India.

Rutik Thorat,
Department of Obstetrics and Gynecology, GMERS Medical College Gotri, Vadodara, Gujarat, India.

Jasmin Jasani,
Department of Pathology, Smt BK Shah Medical Institute & Research Centre, Sumandeep Vidyapeeth an Institution deemed to be University, Piparia, 391760, Vadodara Gujarat, India.

Please see the link here: https://stm.bookpi.org/CODHR-V10/article/view/9394

Lymphatic System and Tuberculosis Affection | Chapter 19 | Current Practice in Medical Science Vol. 4

The immune system includes the lymphatic system, which works in conjunction with the circulatory system. One of the most frequent locations for extrapulmonary TB to occur is lymph nodes. In addition to being the starting point for the adaptive immune system, lymph nodes provide favourable environments for Mycobacterium tuberculosis to proliferate and persist. The symptoms of superficial tuberculous lymphadenopathy might range from a single tuberculous infection to widespread Koch's disease or possibly an underlying significant organ involvement. A comprehensive study is advised if a diagnosis of superficial tuberculous lymphadenopathy is made since the lymphatic system plays a significant role in systemic disease.

Author(s) Details:

Deepali Rahul Gaikwad,

Department of Pulmonology, PCMC’s Postgraduate Institute YCM Hospital, Pimpri, Pune, India.

Please see the link here: https://stm.bookpi.org/CPMS-V4/article/view/7623

A Rare Case of Extra Ovarian Sex Cord Stromal Tumour Presenting as Broad Ligament Mass Synchronous Ovarian Mass; Pathologic Pattern Reveals Mix Granulosa Fibroma, Type of Mix Mesonephric and Mullerian Origin | Chapter 9 | Current Practice in Medical Science Vol. 1

A 30-year-old lady with an abdominal tumour arrived to OPD. Using fine needle aspiration cytology, pappilaryadenocarcinoma was identified as the tumour (FNAC). Cells from palpable nodules in organs or tissues are extracted with FNAC. B/L excision had been used to eliminate the bulk. A broad ligament tumour was found after laparotomy. HPS and IHC were used to identify a malignant high grade mixed sex cord stromal tumour (granulosa and fibroma type).

Author(s) Details:

Smruti Sudha Pattnaik,
Department of Obstetrics and Gynaecology, Acharya Harihara Cancer Centre, Cuttack, Odisha, India.

Sushil Kumaar Giri,
Department of Obstetrics and Gynaecology, Acharya Harihara Cancer Centre, Cuttack, Odisha, India.

Jita Parija,
Department of Obstetrics and Gynaecology, Acharya Harihara Cancer Centre, Cuttack, Odisha, India.

Padmalaya Devi,
Department of Obstetrics and Gynaecology, Acharya Harihara Cancer Centre, Cuttack, Odisha, India.

Kunal Goutam,
Department of Obstetrics and Gynaecology, Acharya Harihara Cancer Centre, Cuttack, Odisha, India.

Janmejaya Mohapatra,
Department of Obstetrics and Gynaecology, Acharya Harihara Cancer Centre, Cuttack, Odisha, India.

Bhagyalaxmi Nayak,
Department of Obstetrics and Gynaecology, Acharya Harihara Cancer Centre, Cuttack, Odisha, India.

Manoranjan Mohapatra,
Department of Obstetrics and Gynaecology, Acharya Harihara Cancer Centre, Cuttack, Odisha, India.

Please see the link here: https://stm.bookpi.org/CPMS-V1/article/view/7328

Significance of Tissue Microbiopsies in Fine Needle Aspiration Cytology- A Prospective Study | Chapter 18 | Recent Developments in Medicine and Medical Research Vol. 9

 Background: Fine needle aspiration cytology is an indispensable tool for both pre-therapeutic inquiry and recurrence diagnosis. The importance of fine needle aspiration cytology (FNAC) in the diagnosis of malignant tumours has been documented. However, a definite diagnosis based solely on FNAC is not always attainable. In routinely analysed FNA smears, there are some difficulties. They often have a very small amount of tissue material, and the lack of discernible tissue architecture in cytology smears makes diagnosis challenging. Traditional fine needle aspiration (FNA) smears frequently contain well-preserved live tissue fragments that are intact (tissue microbiopsies). Micro biopsies are described as live tissue fragments collected from cytology smears that are well maintained. They will contribute to the tumour ontogeny by providing information on tissue architecture. The purpose of this study was to determine the importance of microbiopsies in conventional/guided FNAC in providing a more precise diagnosis.

Aim: To investigate the role of tissue microbiopsies in conventional and guided fine needle aspiration cytology preparation, as well as the utility of microbiopsy fragments in cytological diagnosis precision.

Methods: In the Cytopathology laboratory of the Department of Pathology, Tirunelveli Medical College, Tirunelveli, a prospective study of the importance of tissue microbiopsies in fine needle aspiration cytology was studied and interpreted from June 2014 to June 2015. Swellings that were clinically palpable were evaluated in 100 cases.

Results: Out of 100 instances, 82 percent were classified as conventional FNAC, ten percent as USG guided, and eight percent as CT guided FNAC. With 34 cases (34 percent), lymph nodes had the highest yield of microbiopsies, followed by the breast (24 cases), thyroid (11 cases), lung (eight cases), salivary gland (seven cases), liver (four cases), bone and soft tissue (four cases), abdominal mass (three cases), pancreas (two cases), and ovary, spleen, and anterior mediastinum (one case each). Out of 100 cases, 56 percent were cancerous and 44 percent were benign. There were a total of 56 malignant tumours, with 41 (73.2%) being original tumours and 15 (26.8%) being metastatic tumours.

Conclusion: In situations of metastatic cancers, FNA smears including microbiopsies are more helpful in confirming the diagnosis, typing the tumour, and predicting probable primary sites than cytology alone. As a result, if employed in the evaluation of routine cytology samples, this technique can be used to improve the diagnostic accuracy of FNAC. Fine needle aspiration cytology aspirate with tissue microbiopsy, whether conventional, CT, or USG guided, is a helpful method in evaluating and identifying suspected lumps or tumours.

Author(S) Details

A. R. Jaswanthini
Department of Pathology, Tirunelveli Medical College, Tirunelveli, Tamil Nadu, India.

K. Swaminathan
Department of Pathology, Tirunelveli Medical College, Tirunelveli, Tamil Nadu, India.

View Book:- https://stm.bookpi.org/RDMMR-V9/article/view/4601

Determining the Role of Aspiration Cytology in Splenic Lesions | Chapter 3 | Recent Developments in Medicine and Medical Research Vol. 11

 Background: Since the turn of the century, splenic fine needle aspiration cytology (FNAC) has been utilised as a diagnostic technique, with the first report being in 1916. It has a reputation for being dangerous and difficult to judge, yet these stereotypes are completely false. The FNAC test is still the easiest, cheapest, and safest way to diagnose a problem.

The purpose of this research was to assess and determine the diagnostic value of aspiration cytology in splenic lesions.

Methods: In our retrospective investigation, fine needle aspiration cytology (FNAC) of the spleen was conducted in 34 patients, with 28 cases aspirated under ultrasonological guidance and 6 cases aspirated blindly. There were 23 male and 11 female patients with ages ranging from 2 to 69 years old, as well as 8 juvenile patients. Prior to the procedure, all necessary precautions and testing were completed, including a coagulation profile.

Results: Bloody aspirates were found in five of the 34 FNAC instances, whereas normal splenic aspirates were found in the other two. A definitive diagnosis could be made in 27 of the instances. Extramedullary hematopoiesis was the most common non-neoplastic condition (8 cases), followed by tuberculosis (4 cases), kala azar (3 cases), and storage disease (3 cases), and granulomas (2 cases). In the neoplastic group, we had two cases of non-Hodgkins lymphoma, one case of Hodgkin lymphoma, two cases of hairy cell leukaemia, and one case of histiocytosis. There were no significant variations in cellularity when aspiration was done blindly or with ultrasound assistance. There were no procedural issues uncovered during our investigation.

As a result, when used as a primary inquiry and carried out with extreme caution, FNAC spleen is a safe, low-cost, fast, and highly diagnostic treatment.

Author(S) Details

Shweta Garg
Department of Pathology, LLRM Medical College, Meerut, Uttar Pradesh, India.

Nisha Malik
Department of Pathology, LLRM Medical College, Meerut, Uttar Pradesh, India.

Veena Sharma
Department of Pathology, LLRM Medical College, Meerut, Uttar Pradesh, India.

View Book:- https://stm.bookpi.org/RDMMR-V11/article/view/4645

Extrapulmonary Tuberculosis: Is Cartridge Based Nucleic Acid Amplification Test More Superior to the Conventional Methods in Diagnosis? | Chapter 14 | Recent Developments in Medicine and Medical Research Vol. 4

 The lymph nodes, pleura, central nervous system, bones, gastrointestinal tract, and genitourinary tract are the most common sites of extrapulmonary tuberculosis [EPTB]. Isolated lymphadenopathy and effusion in the bodily cavities are the most common symptoms. Fine Needle Aspiration Cytology [FNAC], Acid Fast Bacilli [AFB] demonstration by Zeihl-Neelson [Z-N] stain, and Cartridge Based Nucleic Acid Amplification Test [CBNAAT] are all tests used to detect EPTB. The data of 100 clinically suspected EPTB patients who had undergone FNAC, CBNAAT, and Z-N stain in Mandya Institute of Medical Sciences, Mandya, Karnataka, was used in a retrospective record-based analysis. After receiving approval from the Institutional Ethics Committee, the study was conducted for four months, from March to June 2018. The analysis found 47 situations where FNAC results favoured EPTB. Thirty of the 47 cases tested positive for CBNAAT. Out of 53 instances with negative FNAC results, 5 had positive CBNAAT. Only 13 of the 35 CBNAAT positive individuals tested positive for AFB. To summarise, because of its high specificity and positive predictive value, CBNAAT is a quick, accurate, and simple test for early detection of EPTB. CBNAAT can also detect cases that FNAC and Z-N stain couldn't.

Author(S) Details

M. U. Mythreyi
Mandya Institute of Medical Sciences, Mandya, Karnataka, India.

M. S. Siddegowda
Mandya Institute of Medical Sciences, Mandya, Karnataka, India.

S. Shivakumar
Mandya Institute of Medical Sciences, Mandya, Karnataka, India.

View Book:- https://stm.bookpi.org/RDMMR-V4/article/view/4179

Determination of Fine Needle Aspiration Cytology: An Important Tool for Diagnosis of Extra Pulmonary Tuberculosis | Chapter 1 | New Frontiers in Medicine and Medical Research Vol. 10

 The goal of this study is to evaluate early tuberculosis diagnosis using a simple and uncomplicated technique, as well as to investigate tuberculosis occurrence at various extrapulmonary sites. Tuberculosis is the most frequent and deadly infectious disease in our country. Tuberculosis can affect every organ system in the body, and while pulmonary tuberculosis is the most common form, extrapulmonary tuberculosis is nonetheless a deadly condition. Extrapulmonary tuberculosis can be diagnosed via Fine Needle Aspiration Cytology. This is a 12-year study of 17,640 cytological smears received in a tertiary care center's cytology lab between January 2000 and March 2012. Of the 17,640 smears, 1038 (5.88%) were found to have tubercular lesions. Our findings show that tuberculosis is more common in women (721 cases, or 69.46 percent) than in men (317 cases, or 30.53 percent), with a male to female ratio of 1:2.27. The lymph node was the most prevalent site in both sexes, accounting for 975 (93.93%) of the 1038 cases. We also discovered that tuberculosis is most common in people aged 14 to 45. Fine Needle Aspiration Cytology is a prominent diagnostic technique that is gaining popularity due to its ease of use, quick findings, and low risk of complications.

Author (S) Details

Archana Shrivastava
Department of Pathology, Gandhi Medical College Bhopal, India.

View Book :- https://stm.bookpi.org/NFMMR-V10/article/view/3500