7. Fine needle aspiration cytology of thyroid nodules using The Bethesda system for reporting thyroid cytopathology.

Background: The objective of this study was to analyze the thyroid cytology smears by The Bethesda system for reporting thyroid cytopathology (TBSRTC), to determine the distribution of diagnostic categories and subcategories, to analyze accuracy rates and to correlate the cytopathology with histopathology, wherever surgery was done. Materials and methods: This is a retrospective study of 130 cases of Fine needle aspiration cytology (FNAC) for thyroid swellings. The reporting of thyroid lesions is carried out using the Bethesda system for reporting of thyroid lesions and correlated when surgical was available. Results: Out of 130 cases studied 9 (6.9%) cases are of Bethesda Category I ; 114 (87.69%) patients showed category II lesion; Benign follicular lesion, 2 (1.54%) patients showed follicular neoplasm, category IV lesion and 5 (3.85 %) patient showed category VI - malignant lesion. The accuracy rate of FNAC on histopathological correlation in diagnosis for category II (Benign follicular lesion), category IV (Follicular Neoplasm) and category VI, (Malignant) lesions were 93.22 %, 100 % and 80 % respectively. Conclusions: Thyroid FNA using the Bethesda system for reporting of thyroid lesions will facilitate communication among cytopathologists, endocrinologists, surgeons, radiologists, and other health care providers; facilitate cytologic-histologic correlation for thyroid diseases; facilitate research into the epidemiology, molecular biology, pathology, and diagnosis of thyroid diseases; and allow easy and reliable sharing of data from different laboratories

Anterior mediastinal masses: A study of 50 cases by fine needle aspiration cytology and core needle biopsy as a diagnostic procedure

Background: Mediastinal tumors are an uncommon abnormalities found in clinical practice. Anterior mediastinum is the common site and tissue diagnoses of anterior mediastinal masses (AMMs) are very important for correct therapeutic decision. Objective: We evaluate the different malignant AMMs in various age groups and the sensitivity of fine needle aspiration cytology (FNAC) and core needle biopsy (CNB). Cytology smears are reviewed with particular emphasis on pitfalls in the cytological diagnosis. Materials and Methods: This was a prospective study of 50 patients who were consulted for AMMs and underwent FNAC and CNB under guidance of ultrasound or computed tomography (CT) scan from 2006 to 2011. Cytology smears and histological sections were evaluated in all patients. Results: Among 50 cases, 36 were male and 14 were female. Most AMMs (52%) were identified in the fifth and sixth decades of life. Metastatic carcinoma and nonHodgkin′s lymphoma are the common AMMs. Adequate tissue material was obtained in 49 of 50 cases by CNB. Of these 49 patients, 35 (71.42%) cases were diagnosed correctly by FNAC, whereas 14 (28.57%) cases were not diagnosed definitely by FNAC. The sensitivity of CNB for AMMs was 97.95%, significantly higher than FNAC (71.42%) ( P 0.05). Diagnostic rate of FNAC was higher for carcinomatous lesions (81.81%) than for noncarcinomatous lesions (62.96%). Conclusion: Ultrasound or CT scan-guided CNB in combination with FNAC are safe, minimally invasive, and cost-effective procedure, which can provide a precise diagnosis in the AMMs, and may obviate the need for invasive surgical approach. FNAC usually suffice for carcinomatous lesions but CNB should be performed whenever the diagnosis of carcinoma is equivocal or noncarcinoma lesions are suspected

Encephalocele presented in late third trimester: a case report

In present era, most of the NTDs are diagnosed at quite early gestation, thanks to advancement in imaging technology. So it is rare to see a case of NTD in late gestational age. Encephalocele is still rare type of NTD, when we come across such a case in late gestational period associated with another risk factor (Previous LSCS), it can really present a challenge for management. We had to face such a case requiring skillful management. A 23 year, G2 P1 L1 with previous LSCS was referred to our institution for severe anemia. USG showed 37 weeks single, live fetus with absence of cranial vault& irregular compressed cystic structure attached to vault attached in occipital region. Previous USG done at 12 weeks showed no abnormality, while USG at 27 weeks showed Acrania. Ideal management of this patient could have been done if this anomaly was diagnosed before 20 weeks where option of MTP was clearly available. Though with high resolution technical and instrument and with expert sonologist encephalocele can be diagnosed by 14 weeks