FINE NEEDLE ASPIRATION CYTOLOGY OF BREAST LUMP IN T.U. TEACHING HOSPITAL

This is a retrospective study of fine needle aspiration cytology of breast lesions performed between May 1998 and April 2000. During this period, a total of 2001 fine needle aspirations were done in the Tribhuvan Universtiy Teaching Hospital (TUTH), of which 470 (23.48 %) were of the breast. Fibrocystic disease found to be the most frequent and was diagnosed in 183 cases (38.9%). Fibroadenoma was the third common pathological condition, numbering 61 (12.9%). Malignant conditions of the breast were 72 cases (15.3%). During these two years, histological diagnosis was available in 154 cases. Histological examination revealed benign conditions in 74 cases (48%), malignancy in 59 cases (38.3%) and inflammatory & lactational changes in 21 cases (13.7%). Out of these 154 cases, 71 cases had also undergone fine needle aspiration cytology. The 36 cases diagnosed as benign cytologically, 34 cases were also benign histologically, whereas 2 cases turned out to be malignant. Out of 37 cases that were histologically malignant, on cytology 35 cases were diagnosed as malignant. The sensitivity and specificity of cytopathological diagnosis for breast lesions was 100% and 94.6% respectively. Inflammatory lesions correlated well cytologically and histolgically. FNAC is a safe and rapid diagnostic method for evaluation of various lesions. However, there are possibilities of false negative and false positive results because of wide range of appearance of breast lesions. Key Words: Breast lumps, Fine Needle Aspiration Cytology, Benign Lesions, Malignant Lesions, Histopathology and Correlation

Doege–Potter Syndrome, cause of nonislet cell tumor hypoglycemia: the first case report from Nepal

Vivek Pant,1 Suman Baral,2 Gita Sayami,3 Prakash Sayami4 1Department of Biochemistry, 2Endocrinology Unit, Department of Medicine, 3Department of Pathology, 4Manmohan Cardiothoracic vascular and transplant Center, Institute of Medicine (IOM), Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal Abstract: Doege–Potter syndrome (DPS), a paraneoplastic syndrome, presents as a hypoinsulinemic hypoglycemia from the ectopic secretion of insulin-like growth factor II from a solitary fibrous tumor which may be intrapleural or extrapleural in origin. We report a case of severe hypoglycemia in a 70-year old female initially admitted for resection of left sided solitary fibrous tumor of pleura. Investigation revealed true hypoglycemia, and DPS was diagnosed. The tumor was completely resected, after which no further hypoglycemic episodes were seen in 2 years follow-up. This is the first case of solitary fibrous tumor of pleura with DPS reported from Nepal. Keywords: insulin-like growth factor II, IGF-II, solitary fibrous tumor, hypoglycemi

INTRAOCULAR MALIGNANT TERATOID MEDULLOEPITHELIOMA

Malignant teratoid medulloepithelioma is an uncommon unilateral intraocular tumor, occuring typically in children. This report concerns a 4-year-old boy, who presented with loss of vision, pain and proptosis of the left eye and showed mass in between eyelids. Histopathologically, the tumor was composed of pseudostratified primitive- appearing epithelium dispersed in cords, strands, tubules & glands, which were separated by a cystic spaces, filled with pale eosinophilic material. Foci of glial tissue, cartilage , bone, skeletal muscle and fatty tissue were recognized. In addition, scleral extension of tumor, Homer-Wright like and Flexner-Wintersteiner like rosettes and foci of necrosis were also present. The differentiation from retinoblastoma was discussed. Key Words: Malignant medulloepithelioma, eyeball, heteroplasia

Closed Mitral Valvotomy During Pregnancy

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