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BACKGROUND Neoplasms of salivary gland account for 2 - 6.5 % of all head and neck neoplasms. Fine needle aspiration cytology (FNAC) is sufficiently sensitive and relevant to the diagnosis and treatment of salivary gland pathologies for salivary gland lesions. The Milan system for reporting salivary gland cytopathology (MSRSGC) represents a stage for a structured, evidence-based international reporting system for salivary gland fine-needle aspiration (FNA). This system provides a guidance for diagnosis and management according to the risk of malignancy (ROM) in different categories. We wanted to study the various cytomorphological lesions of salivary gland and their cytological categorisation based on the MILAN system of reporting. METHODS A 2-year record-based study (January 2018 to December 2019) was conducted on FNAC of salivary gland lesions in the Department of Pathology, VSSIMSAR (Veer Surendra Sai Institute of Medical Sciences and Research), Burla, Odisha. Based on the classical system, all smears were studied and re-categorized into six groups according to the MILAN classification. Histological correlation was carried out in the available cases. RESULTS A total of 103 FNA cases were examined and 20 different categories were there in the original diagnosis. As per the categorisation based on MILAN System there were six categories, maximum cases were non-neoplastic 34 (33.0 %) followed by benign neoplasms 22 (21.35 %), malignant 14 (13.5 %), non-diagnostic 10 (9.7 %), atypia of undetermined significance 9 (8.7 %), suspicious for malignancy 8 (7.7 %) and neoplasms of uncertain malignant potential 6 (5.8 %). 43 cases (80.4 %) were found to be concordant out of 54 histopathology correlated cases. CONCLUSIONS The Milan system of reporting salivary gland cytopathology provided a uniform system of reporting salivary gland cytomorphology that may increase the effectiveness. KEYWORDS Milan System, Salivary Gland Lesions, FNAC, Risk of Malignancy (ROM)

BACKGROUND Lymph nodes (LN) are an integral component of the immune system. Enlarged lymph nodes are a prime target for fine needle aspiration (FNA). Lymph nodes greater than 1 to 2 cm are an immediate source of concern. Lymphadenopathy is a common presenting symptom in various diseases. Fine needle aspiration cytology (FNAC) confirms the presence of metastatic disease and gives a clue regarding its nature and origin of primary malignancy. In many metastatic malignancies, FNAC may be the only tool for diagnosis and further management of the patients. We intend to assess the cytomorphological patterns of both primary tumour and metastatic tumour in a lymph node. METHODS A retrospective study was conducted in the Department of Pathology, RIMS, Imphal, over a period of one year from January 1, 2018 to December 31, 2018. Five hundred and fifty-five lymph nodes were aspirated, out of which 99 cases turned out to be malignant lesions. Giemsa and PAP stained FNAC slides were collected and reviewed. Data entry and analysis were done by using SPSS version 21. RESULTS Out of 99 cases, 88.9 % were metastatic tumours and 11.1 % were of primary lymphoproliferative disorders. Thirty three percent of malignant lymphadenopathy were found in fifth decade. Undifferentiated carcinoma constituted around 32.3 % of all the cases of malignant lymphadenopathy. Cervical group of lymph nodes were involved in 46.5 % of cases. CONCLUSIONS FNAC has proved to be a useful tool in diagnosing malignancy with good certainty. FNAC of lymph nodes prevents complications associated with lymph node biopsy. KEYWORDS FNAC, Lymph Node, Undifferentiated Carcinoma, Squamous Cell Carcinoma

BACKGROUND Fine needle aspiration cytology (FNAC) is a method for the diagnosis of superficial lesions like swellings of the salivary glands since many years. The present study was undertaken to identify the patterns of salivary gland lesions (SGL) on FNAC and histopathology specimens and also describe the age and sex distribution of SGL. METHODS A total 319 cases of SGL were studied from June 2009 to July 2019 which included both retrospective and prospective cases. A detailed history was taken, clinical and necessary laboratory investigations were done; and then FNAC of salivary gland was done. Histopathology examination of specimens was done whenever available; FNAC and histopathology slides of retrospective cases were reviewed. Correlation between cytomorphology and histomorphology was done only where available. RESULTS The majority of cases was in the age group of 21 - 40 years (42.98 %) with female predominance (53 %) and commonest gland involved was parotid gland (52.97 %) in both the sexes. 138 (43 %) cases were non-neoplastic lesions and 181 (57 %) were diagnosed as neoplastic lesions. Of the 138 non neoplastic lesions, on cytology and histopathology, sialadenitis constituted 110 (79.71 %) cases; most being chronic sialadenitis (107). Out of 181 neoplastic lesions, 142 (77.78 %) were benign while 39 (22.22 %) cases were malignant. Pleomorphic adenoma was the commonest benign neoplasm (71.27 %) and mucoepidermoid carcinoma (66.69 %) was the commonest malignant neoplasm. Histopathological correlation was available in 37 cases. CONCLUSIONS FNAC is useful as an outdoor diagnostic procedure because of the availability of earlier diagnosis in comparison with the histopathological diagnosis. Histopathology correlation is helpful in cases where diagnosis at FNAC is difficult. KEYWORDS FNAC, Salivary Glands, Histopathology, Specimens, Cytomorphology, Sialadenitis, Pleomorphic Adenoma, Mucoepidermoid Carcinoma

BACKGROUND Neck swellings consists of a wide spectrum of pathological entities. These swelling can occur due to a variety of aetiologies consisting of congenital, acquired inflammatory, neoplastic, or vascular origin. It is essential to have an extensive knowledge of the anatomy and contents of each cervical compartment to achieve a diagnosis. The age of presentation and clinical findings often narrows down the differential diagnosis. Ultrasonography (USG) is helpful in differentiating the nature of the lesions and differentiating solid from cystic neck lesions. Ultrasound is often used as an initial modality for pre-treatment assessment of any neck swelling. METHODS Patients with clinically palpable / non-palpable neck swellings were scanned using 7.5 - 11 MHz transducers, excluding patients with diagnosed thyroid swellings. RESULTS In total 120 cases were studied; the mean age of patients was 34 years with a male to female ratio of 1.1:1. The age wise categorisation included paediatric population (34.2 %) and adult population (65.8 %). 96 (80 %) cases presented with painless neck swelling, 76 (63.3 %) cases were non-neoplastic and 44 (36.7 %) cases were neoplastic in nature. Cervical lymphadenopathy being the most common ultrasound finding in both paediatric and adult population. Malignant lesions were most common in adult age group. Heterogeneous echotexture, rounded nodes, intranodal necrosis, loss of echogenic hila, peripheral nodal blood flow and increased pulsatility index (PI) and resistive index (RI) were important features of malignant lymph nodes. Sensitivity and specificity of USG and Doppler in differentiating neoplastic from non-neoplastic lesions were 97.7 % and 98.3 % respectively and for differentiating benign from metastatic nodes were 97.7 % and 98.3 % respectively. CONCLUSIONS Considering the study results and observations, USG is the best initial investigation for the evaluation of inflammatory, cystic and neoplastic swellings in various age groups. It is non-invasive, cost effective readily available and repeatable technique. It is relatively easier to use and does not involve radiation hazards. Colour Doppler can evaluate the vascularity of the lesions and provide details of any vascular invasion of metastatic lesions. Ultrasound can differentiate aetiology of lymph node enlargement to a significant extent. KEYWORDS High Resolution Ultrasound, Paediatric Neck Mass, Metastatic Lymph Node, Histopathology, FNAC, Tubercular Lymph Nodes, Colour Doppler, Non-Thyroidal

BACKGROUND Thyroid nodules are common and occur in 4 % - 7 % of the general population. Diseases of the thyroid are of great importance because they are most amenable to medical or surgical management. The benefit of thyroid fine needle aspiration (FNA) derives in large part from the ability to make a reliably benign interpretation that avoids unnecessary surgery. A uniform reporting system for thyroid FNA will facilitate effective communication among cytopathologist and the referring physician and allow easy and reliable sharing of data from different laboratories for national and international collaborative studies. For uniformity of reporting cytological smears “The Bethesda System for Reporting Thyroid Cytopathology” was recommended and the smears were divided into 6 diagnostic categories. We wanted to know the age and sex distribution and prevalence of various thyroid lesions as per Bethesda diagnostic criteria. We wanted to study the cytological and morphological features of thyroid lesions by fine needle aspiration cytology (FNAC). METHODS The present study is a prospective type of descriptive study, carried out from January 2016 to December 2017 at Andhra Medical College, Visakhapatnam. A total of 1291 cases were evaluated and classified according to Bethesda system of cytopathology. FNAC was done and the smears were immediately fixed in isopropyl alcohol and stained with haematoxylin and eosin. RESULTS In the present study a total of 1291 cases was analysed out of which 1193 were benign, 13 were AFLUS, 32 were follicular neoplasms, 10 were suspicious of malignancies and 36 malignant. All the lesions were classified as per Bethesda diagnostic criteria. CONCLUSIONS FNAC is a simple and cost-effective procedure which guides the clinical practitioner to choose the right form of treatment for the patient subsequently avoiding unnecessary surgery and ensuing morbidity. KEYWORDS Thyroid, Cytopathology, FNAC, Bethesda, Follicular Neoplasm, Benign, Malignant

BACKGROUND Breast lump is fairly a common complaint in females for which patient seeks medical advice and becomes anxious about the diagnosis. Quick diagnosis by fineneedle aspiration cytology (FNAC) relieves patient’s anxiety and assists in their preoperative management and overall treatment. This study was conducted to find out the cytomorphological patterns and distribution of breast lesions in various age groups in our institute. METHODS This is a prospective observational study of breast lesions conducted in the Mandya Institute of Medical Sciences, Mandya, for a period of 18 months from January 2016 to June 2017. About 200 cases were studied by cytology and correlated with histopathology wherever biopsy specimens were available, and were stained with haematoxylin and eosin (H & E) and May–Grunwald–Giemsa stains (MGG). Cases were grouped according to the five-tier reporting format for breast lesion (C1 – C5) laid down by National Cancer Institute. RESULTS The spectrum of breast lesions on cytomorphological interpretation was 1 % inadequate / insufficient material (C1), 80 % benign (C2), 1.5 % atypia probably benign (C3), 0.5 % suspicious of malignancy (C4) and 17 % malignant (C5). Out of 200 cases studied, 160 cases were benign lesions, and 34 cases were malignant lesions. Most of the benign lesions belonged to the age group 21 - 30 years followed by 31 - 40 years. Malignant lesions were maximum in the age group of 41 - 50 years. In benign disease, fibroadenoma was the commonest i.e. (31 %) followed by fibrocystic change (22 %), benign epithelial hyperplasia (8.7 %), acute mastitis (3 %), chronic mastitis (2 %), epidermal cyst (1.8 %), subareolar abscess, granulomatous mastitis, galactocele (1 %) and gynaecomastia (8.5 %). In the malignant group, infiltrating ductal carcinoma - not otherwise specified, was the commonest lesion (82.4 %), followed by mucinous carcinoma (8.8 %), papillary carcinoma, medullary carcinoma and metaplastic carcinoma (2.9 %). In this study, the specificity, sensitivity, positive and negative predictive value, and diagnostic accuracy of fine-needle aspiration cytology were 100 %, 90 %, 100 %, 95 %, and 96 %, respectively. CONCLUSIONS FNAC of the breast lump is an easily performed outpatient diagnostic method for determining the nature of the breast mass. KEYWORDS FNAC, Fibroadenoma, Haematoxylin and Eosin, Infiltrating Ductal Carcinoma - Not Otherwise Specified (IDC NOS), May Grunwald Giemsa

BACKGROUND In clinical practice, breast lump is a very common presentation of numerous breast diseases which ranges from benign cysts to malignant lesions. The difference between benign and malignant is very important for patient care and proper management. The diagnosis of breast lump includes clinical examination supplemented by imaging. Various literature has concluded that ultrasound evaluation with fine needle aspiration cytology (FNAC) correlation has comparable sensitivity and specificity to histopathology. Our aim was to study the ultrasonographic characteristics of breast lesions in patients and compare the sensitivity of ultrasonography in diagnosing benign and malignant breast lesions with FNAC. METHODS This is a diagnostic validation study, conducted at Department of Radiodiagnosis and Department of Pathology, Narayan Medical College and Hospital. All females more than 30 years coming for routine breast screening, found to have Breast Imaging Reporting and Data System (BI-RADS) 2 and above were subjected to ultrasonography and FNAC under ultrasonography (USG) guidance, and compared with histopathology. Data was collected, entered and analysed using Microsoft Excel, Epi Info, and SPSS software. Sensitivity and specificity with correlation, positive predictive value (PPV), negative predictive value (NPV) was calculated to compare the two diagnostic modalities. RESULTS USG had 83.3 % sensitivity, 97.56 % specificity, 95.24 % positive predictive value, 90.91 % negative predictive value, 33.32 % positive likelihood ratio and 17.13 % negative likelihood ratio. FNAC had 96.67 % sensitivity, 97.56 % specificity, 96.67 % positive predictive value, 97.56 % negative predictive value, 38.66 % positive likelihood ratio and 3.42 % negative likelihood ratio. CONCLUSIONS Breast ultrasound and FNAC both are important diagnostic tools for breast lesion. Sensitivity, specificity and other features are better for FNAC than ultrasound for breast lump. KEYWORDS Breast Lump, FNAC, USG, Adenocarcinoma, Squamous Cell Carcinoma

BACKGROUND Thyroid cancer has the most rapidly increasing incidence of all major cancers in India. The overall prevalence of thyroid malignancy is approximately 1 - 5 % of all cancers in women and less than 2 % in men. Thyroid nodules are a common clinical finding and have a reported prevalence of 4 – 7 % in the general population. The vast majority of these nodules are non-neoplastic or benign and the risk of malignancy varies from 5 to 10 %. Fine needle aspiration cytology (FNAC) is an efficient and reliable means for the evaluation of thyroid nodules. A key challenge for clinicians is to choose which thyroid nodule is to be investigated further and treated. Early detection and treatment of malignant thyroid nodules is associated with excellent outcomes. The aim of our study is to compare and correlate between fine needle aspiration cytology and histopathology of resected specimen and to determine the diagnostic accuracy of TBSRTC (The Bethesda System for Reporting Thyroid Cytopathology) in thyroid nodule. METHODS This is a cross sectional validation study conducted in a tertiary care hospital (R.G. Kar Medical College) of Kolkata to find the sensitivity, specificity and diagnostic accuracy of TBSRTC in evaluation of thyroid nodule. RESULTS We have observed that TBSRTC is highly sensitive and specific in stratifying the malignancy risk of thyroid nodule. CONCLUSIONS It aids the clinician to choose the thyroid nodules which require further evaluation and intervention. It also guides the clinician to decide the operability of thyroid nodule. TBSRTC is highly accurate and is highly specific in stratifying the risk of malignancy of thyroid nodule. KEYWORDS TBSRTC, FNAC, Thyroid Nodules, Thyroid Cancer

BACKGROUND Lymphadenopathy is one of the commonest presentations in clinical practice. Fine Needle Aspiration Cytology (FNAC) is an established, easy, cost effective, diagnostic tool for lymphadenopathies. Judicious application of FNAC can avoid the need of biopsy. We wanted to compare the accuracy of FNAC and histological analysis of peripheral lymphadenopathy among patients visiting the Departments of Oncology, Pathology, Surgery of K.D. Medical College and determine the most prevalent cause of peripheral lymphadenopathy among different age groups of patients. METHODS This study was done among cases of peripheral lymphadenopathy whose FNAC & biopsy were available. 112 cases of lymph node FNACs were carried out in the Dept. of Pathology for a period of one and half years from July 2018 till December 2019. Special stains were used whenever necessary. RESULTS Out of 112 cases studied 68 cases were male and 44 cases were female. Ratio of M : F = 1.5. The commonest anatomical site for lymphadenopathy was cervical (70 %) followed by supraclavicular (13 %) and axillary (10 %). Coming to the spectrum of the disease 103 cases (91.9 %) were non neoplastic lesions and 9 cases 8.03 % were neoplastic lesions. Reactive hyperplastic was the most common condition 51 cases (45.5 %) followed by tuberculosis 34 cases (30.35 %). Out of cases 9 cases (8.03 %) of malignancy, 5 cases (4.4 %) were metastatic deposits & 4 cases (3.57 %) were lymphomas. The peak age group ranged between 21 - 30 years. Cervical location of distribution of lymphadenopathy is noticed to be highest (70 %), which is then followed by, supra clavicular (13 %), axillary (10 %) and inguinal (5 %). (Maximum number of cases were found in the age group of 21 yr. - 30 yr., least number of cases seen in the age group of 61 yr. – 70 yr. Correlative study between cytopathological &and histopathological examination of lymphadenopathy showed diagnostic discordance in three cases and concordance in 109 cases. CONCLUSIONS Apart from reactive hyperplasia, tuberculosis is the commonest cause of lymphadenopathy & males are commonly affected. FNAC is a safe procedure with high degree of sensitivity and specificity and concordance of 96.64 % with histopathological diagnosis. For confirming the diagnosis of lymph nodes, histopathology is the gold standard. KEYWORDS Lymphadenopathy, FNAC, Histopathology, Biopsy, Tuberculosis

BACKGROUND Ultrasonography (US) has become popular in the present day practice in the evaluation of breast lesions. The USG findings can be supplemented by fine needle aspiration cytology (FNAC) and correlation between the two diagnostic modalities can help improve the diagnosis. We wanted to study the ultrasonographic features of breast lumps and to correlate the findings with fine needle aspiration cytology. METHODS This was a prospective study done on 55 patients of breast lumps who attended the ultrasound at department of Radiology, Maheshwara Medical College, Patancheru, Hyderabad, Telangana over a period of eight months. RESULTS Majority of the cases were reported as Benign i.e., 81.8 % (45 / 55), 12.7 % (07 / 55) constituted Malignant cases. Suspicious of malignancy in 5.4 % (03 / 55) cases. Most of the benign lesions were noted in the 20 - 50 years age group while malignant lesions were observed between 41 years to more than 60 years of age. The sensitivity, specificity, PPV and NPV of ultrasonography and FNAC in diagnosing breast lesions were 87.5 %, 93.6 %, 70 %, and 97.7 % respectively. CONCLUSIONS Ultrasonography is a primary imaging technique for evaluation of breast lumps and has good sensitivity, specificity, PPV and NPV for diagnosing breast lesions. It is complementary to FNAC and when both modalities are used together they can diagnose majority of the lesions. This can reduce the radiation exposure and the more invasive and expensive breast biopsy procedure. KEYWORDS USG, Breast Lesions, FNAC, BIRADS

BACKGROUND Salivary gland swellings are one of the common presenting symptoms in the outpatient department. These swellings are referred to the pathology department for determining the exact nature of the lesion to reach a diagnosis. Fine needle aspiration (FNA) of the salivary gland and diagnosis of the disease represents one of the most challenging areas in cytopathology. FNAC is widely used for preoperative diagnosis of many swellings and masses, including salivary gland lesions. It is a cost-effective, safe and straightforward procedure that provides valuable information for planning appropriate management. The present study aims to evaluate the efficacy and cytological spectrum of FNA of salivary gland lesions done over a fixed period in Government Medical College / Government General Hospital, Anantapuramu. METHODS This cross-sectional study was conducted in the Department of Pathology of Government Medical College / Government General Hospital, Anantapuramu, during the period January 2017 to December 2019. Patients with suspected salivary gland enlargements, who were referred for FNAC, were included in this study. FNAs of 80 patients were studied in the present study. FNAC was performed by using a 10 mL syringe with a 23 g needle. Smears were stained by using the H & E stain (Haematoxylin and Eosin). The data collected was entered into an Excel sheet and analysed. Chi-square and p-value were calculated using Open Epi software. RESULTS Cytology slides prepared were studied, interpreted, and the diagnosis made was analysed. Out of the 80 FNAC salivary gland lesions, 44 were non-neoplastic lesions, and 36 were neoplastic lesions. Of the non-neoplastic lesions, chronic sialadenitis was predominant (30), and among the neoplastic lesions, pleomorphic adenoma cases were dominant, accounting for 30 cases. In our study, the most common major salivary gland involved was the parotid gland. CONCLUSIONS FNAC of the salivary gland lesion is a simple, safe, rapid, cost-effective, convenient, harmless, well-tolerated procedure by patients, and it remains an accurate method for the diagnosis of salivary gland lesion for pathologists and physicians. Our study reflected a varied spectrum of lesions in patients referred for FNAC for the diagnosis of swellings of salivary glands. KEYWORDS FNAC, Cytology, Salivary Gland, Parotid, Pleomorphic Adenoma

BACKGROUND Thyroid cancer is the most common endocrine cancer and has the highest mortality among endocrine neoplasms. The incidence of thyroid malignancies has increased three-fold over the past three decades. Even though thyroid cancer is more common in women than in men, death from thyroid cancer is more common in men. Thyroid cancers display a wide range of aggressiveness from the more indolent papillary cancer to the uniformly lethal anaplastic cancer. Progression is slow in differentiated carcinoma. Progression is rapid in anaplastic carcinoma. Even though majority of thyroid swellings are benign, some may harbour malignancy. So, accurate clinical examination, workup and evaluation are required. METHODS Patients admitted in surgery wards, Andhra Medical College, King George Hospital, Visakhapatnam, from July 2017 to September 2019 diagnosed with thyroid cancer on post-op histopathological examination were included in the study. The study was conducted among 50 patients. RESULTS Thyroid malignancy incidence is more in female patients i.e. 40 out of 50 patients (80%). Thyroid malignancy incidence is more in 31 - 40 years age group (28%) followed by 41 - 50 years age group (24%). Papillary carcinoma was the most common in this study (80%) followed by follicular carcinoma in 14% of patients. Swelling is the most common clinical feature which is present in all the cases (100%), followed by neck node swellings in 20 patients (40%). Distant metastasis was present in only one case (2%). Preoperative complications were tracheal deviation (20%), calcifications (14%), and retro sternal extension (1%). CONCLUSIONS Thyroid disorders are quite common in our geographical area. Carcinoma thyroid is 3 rd most common among the thyroid diseases. In the present study, papillary carcinoma is the most common type followed by follicular carcinoma. The mean age of presentation is 45 years. A large number of patients belonged to American Joint Committee on Cancer Classification of Thyroid Cancer, Eighth Edition (2017) stage I (

BACKGROUND The diagnosis of articular pathology has been dependent on imaging techniques. But many lesions may require early aspiration cytology for a definitive diagnosis. These include lesions of the joint, joint space and periarticular soft tissues that have a propensity to produce mass lesions. Fine needle aspiration cytology can provide a rapid and reliable diagnosis, often at considerably less cost. We wanted to study cytomorphology of articular and periarticular lesions by fine needle aspiration cytology (FNAC). METHODS The present study is a retrospective study done over a period of 1 year from July 2018 to July 2019 in Cytology section of Upgraded Department of Pathology, Osmania General Hospital, a tertiary care hospital. A total of 89 cases were evaluated during this period from different articular and periarticular sites. RESULTS In the present study out of 89 cases, there were 50 (56.1%) cases of ganglion cysts, 10 (11.2%) cases of bursal cysts, 9 (10.1%) cases of synovial cysts, 8 (8.9%) cases of giant cell tumors of tendon sheath, 6 (6.7%) cases of spindle cell lesions, 5 (5.6%) cases of acute suppurative lesions and 1 (1.1%) case of gouty arthropathy. The male to female ratio (M: F) was 1.2:1 and were predominantly found in third decade of life (21-30 years). Most of the lesions occurred around wrist joint followed by around knee joint and interphalangeal joints of fingers. CONCLUSIONS FNAC, being a low-cost outpatient procedure, is of great diagnostic utility in articular and periarticular lesions. It is minimally invasive and helpful in rapid diagnosis.

BACKGROUND Palpable breast lumps are a common occurrence in women all over the world. The prevalence of non-neoplastic and neoplastic lesions varies from region to region. Fine Needle Aspiration Cytology (FNAC) is a rapid, minimally invasive, reliable and relatively simple diagnostic method. We wanted to study the frequencies of different lesions in FNAC of breast lump in our region and to observe cyto-histological correlation wherever possible. METHODS A two years prospective study was carried out in the department of pathology, RIMS, Imphal during the period January 2016 - December 2017. A total of 434 cases of breast lesions were encountered during this period. RESULTS Of the total 434 cases infectious/inflammatory lesions were 100 (23.1%), benign 268 (61.7%), malignant 40 (9.2%), suspicious for malignancy 02 (0.5%), unsatisfactory 18 (4.1%), and others 6 (1.4%). The most frequent infectious/inflammatory lesion was acute mastitis in 50 (11.5%) followed by sub-areolar abscess in 17 (3.9%) and fat necrosis in 17 (3.9%). Fibroadenoma in 142 (32.7%) cases was the most common benign breast lesion followed by benign proliferative breast lesion without atypia 14 (22.1%). Among the malignant, 39 (9%) cases were carcinoma and one case (0.2%) was lymphoma. Mean age of presentation was 32.82 years. Most commonly involved age group was 21-30 years and right breast was more commonly involved. Cytohistological correlation was done in 41 cases and 35 benign and 6 malignant cases diagnosed cytologically were confirmed by histology, though there were cases with variable diagnosis. So, in differenting benign from malignant lesions, the sensitivity, specificity, positive predictive value, negative predictive value was 100%. CONCLUSIONS FNAC is a reliable and rapid diagnostic tool in the workup of breast lesions. It also helps in differentiating between benign and malignant breast lesions and plays an important role in management of the patient.

BACKGROUND Lymph nodes are an important part of immune system. Their enlargement is noted in a wide spectrum of diseases, including infections and malignancies, which are a common finding in clinical practice. Lymphadenopathy is common in all age groups and management of cases depends on the pathology, which can be studied by collecting material through fine-needle aspiration cytology. MATERIALS AND METHODS A prospective study of FNAC of 1000 cases of lymphadenopathy presenting to the Department of Pathology for 5 years. RESULTS Non-neoplastic lesions account for 72.3% with neoplastic lesions accounting 27.7%. Reactive hyperplasia was seen most often (40.3%) followed by Tubercular lymphadenitis (29.3%). Metastasis was seen in 26.4% where squamous cell deposits were commonest. Cervical lymph nodes were involved most often in all types of lymphadenopathy. CONCLUSION Reactive hyperplasia and tubercular lymphadenitis were the most common among patients presenting with lymph node swellings. FNAC is a simple, safe, reliable, and inexpensive method in early detection of lymph node lesions.

BACKGROUND Fine Needle Aspiration Cytology (FNAC) has become an invaluable tool in the preoperative evaluation of the breast lumps and is a part of initial screening by triple assessment approach. Its main purpose is to differentiate benign lesions from malignant lesions. However inflammatory lesions of the breast are relatively uncommon benign breast lesions and can be of an abnormal finding on imaging. These lesions form palpable lumps and simulate a malignant process, both clinically and radiologically. Core biopsies may not help in the diagnosis of inflammatory lesions and are not necessary in most of these cases. Here, the present study aims to highlight the importance of FNAC in the diagnosis of inflammatory lesions of the breast. MATERIALS AND METHODS The present study was a prospective study conducted in Government General Hospital, Rangaraya Medical College, Kakinada, for a period of one year from July 2017 to June 2018. A total number of 591 female patients with palpable breast lumps were subjected to FNAC. Ten cases out of 591 were showed clinical and radiological discrepancies. Aspirated smears were studied microscopically, and final diagnosis was made after assessment by two pathologists. All ten cases were followed up for six months to assess the response to therapy. RESULTS Ten cases of uncommon inflammatory breast lesions out of 591 breast cases were included in the present study. All patients were females belonging to the age group between 28-55 years. Of these nine cases, 05 cases were of Tuberculosis, 2 cases of Filariasis, 2 cases of sinus histiocytosis with massive lymphadenopathy and 1 case of implant-related granulomatous inflammation. CONCLUSION Careful screening of fine needle aspiration cytology smears is helpful in diagnosing inflammatory breast lesions with specific etiology especially tuberculosis and microfilaria. Diagnosis of such cases allows swift and specific medical therapy where possible and prevents subsequent complications of the disease thereby avoiding unnecessary surgical intervention. The utility of FNAC initially started to diagnose malignant lesions got extended to the preoperative evaluation of both benign and malignant lesions.

BACKGROUND FNCC (Fine Needle Capillary Cytology) and FNAC (Fine Needle Aspiration Cytology) are two fine established techniques, for cytodiagnosis in case of a thyroid nodule, which is a rich vascular organ. Comparative study is conducted to observe merits and demerits of these techniques. MATERIALS AND METHODS 100 patients with thyroid lump (swelling) were examined clinically, to assess the overall size and consistency of lump. Cytological procedure is performed in supine position with neck extended. FNCC was done first, followed by FNAC in each case. 4-5 slides prepared for both modalities of cytological technique and were then stained appropriately. RESULTS Out of 100 patients, 91 were female and 9 were male. 58% of patients were in the age group of 21-40 yrs. Colloid goiter was the commonest lesion accounting for 52% of cases. Diagnostic adequacy of sample was found to be nearly same in both FNCC and FNAC techniques. FNCC was found to be diagnostically superior in case of malignant lesion. Cytological smears in case of FNAC was found to be more adequate but with a haemorrhagic background. CONCLUSION FNCC technique is safe, easy and patient friendly. Diagnostically both techniques show equivalent results. In case of highly vascular lesion it is advisable to perform FNCC to establish the cytodiagnosis.

BACKGROUND Recent trends towards delayed child bearing have bolstered efforts to preserve ovarian tissue throughout the reproductive years. This trend combined with improvements in technology of high frequency sonography and increasing experience in cytopathological interpretation of ovarian cyst fluid has led to broader acceptance and utilization of ovarian FNAC. MATERIALS AND METHODS The study was undertaken on 47 patients from February 2003 to March 2005. FNAC of ovarian lesions by using 23 Gauge needle and Cameco syringe pistol with disposable 10 cc syringe and whenever required use of USG or CT guidance. The technique of aspiration and preparation of the slides closely followed those recommended by Franzen and Zajicek et al. RESULTS The study included 47 cases of which 55.32% were benign and 44.68% were malignant. The commonest benign tumour was simple ovarian cyst (13cases) and the commonest malignant tumour was mucinous cyst adenocarcinoma (09 cases). 13 (27.65%) cases were simple cysts which formed the major portion of this study.09 (19.14%) cases were diagnosed as mucinous cystadenocarcinoma. 08 (17.02%) cases were diagnosed as serous cystadenocarcinoma. Serous cyst adenocarcinomas in 02 cases were bilateral. Recurrence was diagnosed in 02 cases of known mucinous cystadenocarcinomas and 01 case of serous cystadenocarcinoma. CONCLUSION So, with the knowledge of limitations of FNAC, judicial use of this procedure along with detailed clinical history, use of USG/CT guidance and a skilful procedure as well as interpretation of smears, this method proves to be very effective and rewarding.

BACKGROUND The aim of this study was to compare diagnostic accuracy of Cytopuncture with Fine Needle Aspiration Cytology (FNAC) in cervical lymphadenopathy. MATERIALS AND METHODS This is a prospective study conducted on 100 patients between January 2017 and December 2017 in a tertiary care center. Patients with cervical lymphadenopathy were subjected to both FNAC & Cytopuncture after clinical examination. The two techniques were compared for the five objective parameters, using Mair’s point scoring system. RESULTS A total of 100 cases of various diagnostic findings were subjected to statistical analysis. Common clinical diagnosis observed in the study was chronic cervical lymphadenitis– 58%, acute cervical lymphadenitis- 24%, secondaries in neck- 12%, TB lymphadenitis- 6%. On comparing FNAC and cytopuncture, both the techniques yielded comparable results in granulomatous lymphadenitis, metastatic deposits, nonspecific lymphadenitis, and in malignancy, but cytopuncture was diagnostically inferior in acute inflammatory lesion and in reactive lymphadenitis. CONCLUSION FNAC and cytopuncture shows comparable results for granulomatous lymphadenitis, metastatic deposits, nonspecific lymphadenitis and in malignancy for all 5 parameters, but cytopuncture was diagnostically inferior in acute inflammatory lesion and in reactive lymphadenitis.

BACKGROUND Lesions of thyroid are the common finding in the general practice. With the availability of thyroid function tests widely, awareness about thyroid diseases increased in general population, fine needle aspiration cytology became the standard for investigating thyroid lesions along with ultrasound examination and serum thyroid function assays. Fine needle aspiration cytology is cost effective and more specific investigation for palpable thyroid lesions when compared to ultrasound examination. Though ultrasound-guided fine needle aspiration is more sensitive, but availability and economic burden makes FNAC a widely used investigation. Our study is retrospective analysis of cytology findings of 148 cases of thyroid lesions who referred to our department between March 2016 to February 2017. MATERIALS AND METHODS Fine needle aspiration of palpable thyroid lesion patients referred from various other departments from March 2016 to February 2017. Alcohol fixed slides were stained with haematoxylin eosin stain and also with PAP stain. RESULTS Our study finds that solitary nodule of thyroid were most common lesions referred for FNAC in our institute. 22.29% of cases were neoplastic lesions and 77.71% were non-neoplastic lesions. 28.57% (n=24) of solitary nodules was diagnosed as neoplastic lesions with 14.2% (n=12) were diagnosed as papillary carcinoma. CONCLUSION Our study emphasised on investigating solitary nodules of thyroid with FNAC leads to identification of malignant and potentially malignant lesions with better predictive value and recommends the FNAC as a mandatory investigating tool to detect early malignancy and potentially malignant lesions.

BACKGROUND Thyroid disorders are the most common endocrine disorder seen in clinical practice and solitary thyroid nodule is one of the common presentations of thyroid disease. A discrete swelling in an otherwise impalpable gland is termed isolated or solitary nodule of thyroid.1 The prevalence of thyroid nodule increases from near zero at 15 years to 50% by about 60 to 65 years on sonography. At most 10% of these nodules are palpable even by experienced clinicians. This study is about the clinical presentation, histopathology and management of solitary nodule thyroid in MGM GH Tiruchirappalli. AIMS AND OBJECTIVES- To determine the age and sex incidence among the cases of solitary nodule thyroid. To study the percentage of euthyroid, hypothyroid or hyperthyroid state in patients presenting with solitary nodule thyroid. To study the proportion of malignant and benign cases among the solitary nodule thyroid at M.G.M. Govt. Hospital, Tiruchirappalli. MATERIALS AND METHODS This study includes 58 cases of solitary nodule of thyroid noted during the period Jan 2016-Dec 2016. Factors were tabulated and analysed statistically. RESULTS From the present study, the mean age at presentation found to be 42.5 years with preponderance to females. Because of periods of fluctuations in the demands of the hormonal requirement in female in their life cycle (puberty, menstrual cycles, pregnancy, menopause), the chances of thyroid nodule formation are very high as compared with male counterparts. From the study, distribution of malignancy is about 10.34. The incidence of malignancy found to be 12%, sensitivity is 87.5%, specificity is 100% for FNAC and HPE. CONCLUSION Majority of the patients are between 30-49 years of age. Incidence of solitary thyroid nodule is more common in female. Female: male ratio is almost about 15:1 Commonest symptom is swelling over anterior or lateral aspect of neck Among the benign lesion dominant nodule is most common and papillary and follicular carcinoma are common in malignant lesion.

BACKGROUND The quest for accurate diagnosis of lung pathology has been there all through the history of medicine. The pathologist is the person who makes the final diagnosis, but submission of the lesion to the pathologist involves procedures, both invasive and noninvasive like Open Lung Biopsy (OLB), Percutaneous Transthoracic Needle Biopsy (PTNB) and Fine-Needle Aspiration Cytology (FNAC). Percutaneous nonoperative procedures in the chest were performed even before the advent of imaging. Leyden performed the first transthoracic needle lung biopsy in 1882 to confirm pulmonary infection. MATERIALS AND METHODS This is a hospital-based observational study of CT-guided interventional procedures in patients with thoracic lesions diagnosed by imaging methods like chest radiograph, CT or MRI scans. These patients were referred to the Department of Radiodiagnosis for CT-guided thoracic interventions from the Chest Medicine Department and other clinical departments of our hospital (The Oxford Medical College, Hospital and Research Centre). The duration of the study was for a period of 18 months from November 2015 to May 2017. RESULTS Yield of CT-guided fine needle aspiration cytology of thoracic lesions in this study was 28.57% with a failure rate of 71.43%. Yield of CT-guided core needle biopsy of thoracic lesions in this study was 100% with no failure rate. CONCLUSION Percutaneous CT-guided interventions like core biopsy and fine needle aspiration cytology are relatively simple minimallyinvasive procedures with good patient acceptance, low morbidity and almost negligible mortality.

BACKGROUND There are nearly 9 million new cases and 2 million deaths from tuberculosis worldwide every year. 1 The incidence of mycobacterial lymphadenitis has increased in parallel with the increase in the incidence of mycobacterial infection worldwide. Tubercular lymphadenitis is seen in nearly 35 percent of extrapulmonary tuberculosis. Cervical lymph nodes is the most common site of involvement. MATERIALS AND METHODS Every patient out of 116 patients with TB cervical lymphadenitis was investigated with chest x-ray, sputum for AFB, Mantoux test, USG neck, FNAC, FNAC culture on LJ media and excision biopsy. RESULTS Biopsy of cervical lymph node is the best investigation for diagnosis of tubercular lymphadenitis and hence considered as a gold standard. The sensitivity of Mantoux test was 82.4% and specificity was 68.6%. Sensitivity of FNA culture on LJ media was 84.6% and specificity was 72.3%. Sensitivity of FNAC was 84.1% and specificity was 65.5%. Sensitivity of ultrasonography was 92.4%, whereas specificity was 64.2% and sensitivity of excision biopsy was 96.4% and specificity was 88.4%. CONCLUSION On comparison with lymph node biopsy, ultrasonography of neck showed high sensitivity followed by FNA culture on LJ medium, FNAC and Mantoux test, whereas on comparing specificity, FNA culture on LJ medium had a high specificity followed Mantoux test, FNAC and ultrasonography. To achieve a high specificity and sensitivity for diagnosis of tubercular lymphadenitis, a combination of two or more investigations can be used, but more studies are required to evaluate the optimal combination of these investigations for accurate and cost-effective analysis.

BACKGROUND Fine Needle Aspiration Cytology (FNAC) of thyroid neoplasms has its own pitfalls when used alone. This study was undertaken to evaluate whether overexpression of galectin-3 can make a presurgical diagnosis of malignant thyroid neoplasms on FNAC (by immunocytochemistry). TTF-1 was also included in the study to identify the thyroid origin of cells. MATERIALS AND METHODS The study sample included patients with solitary thyroid nodules who underwent FNAC and subsequent surgery at our hospital. The study design was based on diagnostic test evaluation. Immunocytochemistry was performed with galectin-3 and TTF-1 on fresh FNA smears by the standard protocol. Grading was done for galectin-3 positivity based on intensity of immunostaining from grade 1 to 3. Postoperative histological diagnosis represented the gold standard. RESULTS 39 solitary thyroid nodules were studied. TTF-1 was positive in 37 out of 39 cases. Galectin-3 was positive in all malignant cases. It showed a sensitivity of 94% and a specificity of 91% in detecting malignancy. Also, grade 3 immunopositivity for Gal-3 was seen only in papillary carcinoma. CONCLUSION Galectin-3 expression is thus a reliable marker of malignancy (particularly in papillary carcinoma) and grading of Gal-3 immunostaining correlates with malignant transformation. The study also reiterates the efficacy of immunocytochemistry on cytological smears.

BACKGROUND Textile industry workers face so many health-related challenges compared to the general population. Lymphadenopathy is one of the most common presenting symptoms of these people. This study is done in inhabitants of Tiruppur, a major textile industry area in the state of Tamil Nadu, India, where people work in garment factories for low wages. The aim of the study is to- 1. Evaluate the usefulness of Fine Needle Aspiration Cytology (FNAC) as a diagnostic tool in cases of cervical lymphadenopathy. 2. Analyse the various cytomorphological presentations of tuberculous lymphadenopathy. MATERIALS AND METHODS In this study, a spectrum of lesions was diagnosed by fine needle aspiration of lymph nodes of 56 patients presenting with cervical lymphadenopathy. The diseases were categorised into suppurative lymphadenitis, granulomatous lymphadenitis, metastatic tumour deposits and lymphoproliferative disorder. Various morphological presentations of tuberculous lymphadenitis were also analysed. RESULTS From this study, it is observed that the most common diagnosis of cervical lymphadenopathy is reactive lymphadenitis (34%), followed by granulomatous lymphadenitis (30%). Also, among the tuberculosis cases, it is found that majority of cases had only granulomas (45%) followed by caseous necrosis with granulomas (28%). CONCLUSION Knowing the usefulness of FNAC, it is concluded that it is a valuable, noninvasive, reliable and cost-effective technique in such a high-risk population. It also helps the clinician to start treatment based on FNAC findings and do the necessary at the earliest.

BACKGROUND Thyroid carcinoma is the most common cancer in the world. The study aimed to look in to incidence of malignancy in solitary thyroid nodule and prevalence of different types of malignancy. MATERIALS AND METHODS A prospective clinicopathological study of 151 patients diagnosed clinically as Solitary thyroid nodule evaluated and treated in King George hospital, Andhra medical college, Visakhapatnam over a period of 2 yrs. and 2 months from September 2015 to October 2017. RESULTS Out of 151 cases, 133(88.08%) solitary thyroid nodules are benign, 18(11.92%) are malignant. Out of 18 malignant cases, 11 (61.11%) are papillary thyroid carcinoma, 6(33.33%) are follicular thyroid carcinoma, 1 (5.55%) is medullary thyroid carcinoma. The peak age incidence of SNT is in the fourth decade of life (52 cases) and fifth decade (37 cases) followed by third decade (27 cases). The youngest being 15 years old girl and the oldest being 75 years old woman. Mean age is 39.10. The peak age incidence of malignancy in SNT is in the fifth decade of life (7 cases). CONCLUSION Since the finding of a thyroid nodule is a common clinical problem and the proportion of such nodules that prove to be malignant is small, investigations are of immense help to corroborate with the clinical and morphological findings.

INTRODUCTION Neck nodules are common in clinical practice which are accessible to Fine needle aspiration cytology (FNAC). Thyroid being the commonest organ to present as the nodular lesions. Parathyroid lesions can be incidentally encountered during FNA of a thyroid nodule Fine needle aspiration cytology is a safe economical and leading investigation in the diagnosis of neck nodules. Thyroid and parathyroid nodules are indistinguishable clinically. An attempt is made to familiarise the pathologist about the cytomorphological features of parathyroid nodules and simple approach to differentiate from thyroid nodules. MATERIALS AND METHODS It is a retrospective study conducted over a period of 5 years from 2011-2016. Twelve cases of histologically proven parathyroidal lesions are the subjects of study of which 4 cases were diagnosed as parathyroidal cyst and rest as parathyroid adenoma. All the cases underwent fine needle aspiration cytology under ultrasound guidance, Smears were made, stained by H & E and PAP staining method, the slides were reviewed by two cytopathologists. Biochemical and radiological findings were evaluated before giving definitive cytological diagnosis. RESULTS A total number of 12 cases which were histologically proven as parathyroidal lesion. Out of which 4 were cystic lesions which were excluded from the study. Rest of the 8 cases confirmed as parathyroid adenoma which had FNAC were evaluated. 5 cases had positive cytohistological correlation. Three out of 8 cases were diagnosed as papillary carcinoma of thyroid, Toxic nodular goitre and Hurthle cell neoplasm due to varied cytomorphology. CONCLUSION Parathyroidal lesions has got low sensitivity and specificity in cytology. The confident diagnosis of parathyroid neoplasm was made in conjunction with biochemical and advanced radiological imaging. In neck nodules which are asymptomatic and at abnormal locations, FNAC through its cytomorphological features has an edge in diagnosis.

AIM To study the role of FNAC in eyelid and orbital lesions. To evaluate the safety profile of FNAC and its primary role in secondary orbital tumours. MATERIALS AND METHOD In this retrospective study, 30 cases were studied for a period of 1 year from March 2011 to March 2012, which includes 20 eyelid lesions and 10 anterior orbital lesions that presented to our Outpatient Department of Orbit and Oculoplasty. RESULTS Among the 20 eyelid lesions, aspirates of 19 were found adequate for the FNAC diagnosis that is sample adequacy of 95%. Only 1 aspirate (10%) was found inadequate. Similarly, among the 10 orbital cases, sample adequacy of 90% (9 cases) were noted and 1 aspirate (10%) was found inadequate. Of the 19 adequate eyelid lesion aspirates, 73.68% (14 aspirates) were found positive for malignancy, while the remaining 26.31% (5 aspirates) were reported as benign. Similarly, out of 9 adequate orbital aspirates, 77.77% (7 cases) showed positivity for malignancy, remaining 22.22% (2 cases) showed benign nature. Out of the 19 adequate eyelid lesion aspirates, 89.47% (17 aspirates) showed an exact correlation with the HPE results. Remaining 10.52% (2 aspirates) showed indefinite diagnosis, which had shown the lesion to be a benign spindle tumour, HPE confirmed these aspirates as Neurofibroma. Out of the 9 adequate orbital lesion aspirates, exact correlation was found in 88.88% (8 aspirates) and Indefinite diagnosis was seen in 11.11% (1 aspirate) which had shown the lesion as benign spindle lesion. HPE confirmed this as neurofibroma. All the cytology reports of 30 cases were received within 6 hours of sending the aspirate. CONCLUSION Fine Needle Aspiration Cytology of the eyelids and orbit lesions is a safe procedure. It can be done without anaesthesia in outpatient department and can be done in patients who are not fit for anaesthesia. It delivers results within 5–6 hours. It differentiates lesions as benign or malignant very easily. It can be considered as a first diagnostic investigation of choice in tumours such as lymphoma, metastatic tumours and infections that do not require surgical intervention for treatment. It gives rapid results and correlates highly with biopsy proven HPE. FNAC can be considered as a primary investigation in the diagnosis of eyelid and orbital lesions and it can be done safely as an outpatient procedure.

INTRODUCTION Guided fine-needle aspiration cytology (FNAC) is an easy, rapid, minimally invasive and a cost effective diagnostic method for detecting benign and malignant lesions of liver. AIM The main aim of the present study was to establish the incidence of various hepatic lesions and to find out adequacy and utility of the procedure. MATERIAL AND METHOD A total of 174 cases were included in the study from Government Medical College, Kota and associated hospitals. All cases diagnosed to have single or multiple hepatic mass lesions on USG were included in the study. RESULTS Most common age group affected by hepatic lesion was 51-60 years (34.0%). 91.4% cases were having adequate aspirates. 95.6% of the total diagnosed cases were malignant and among malignant cases majority were metastatic. CONCLUSION USG-guided FNAC is a very useful procedure in the diagnosis of hepatic lesions as the procedure is simple and safe. Thus, FNAC is a simple and effective diagnostic tool in our hand.

BACKGROUND Epididymal nodules are frequently encountered in surgical practice. They are easily accessible to fine needle aspiration cytology (FNAC). Clinically, these nodules present as worrisome nodules to the patients as well to the patients. This study was conducted to study the clinico-pathological profile of patients presenting with epididymal nodule using fine needle aspiration cytology (FNAC). METHODS A retrospective study was done by critically analysing the FNAC reports of palpable epididymal swellings in last five years (January 2010 to December 2015) at the Department of Pathology, Regional Institute of Medical Sciences (RIMS) Hospital, Imphal, Manipur. Review of all the reports were done and diagnosis was made according to standard guidelines and correlated with patient’s age, sex, and side of involvement to explore the disease pattern. RESULTS A total of 71 cases were retrieved and divided as follows: Tuberculous epididymitis 20(28.17%), spermatocoele 11(15.49%), non-specific chronic epididymitis 10(14.08%), spermatic granulomas 6(8.45%), acute epididymitis 6(8.45%), hydrocoele 5 (7.04%), adenomatoid tumour 4(6.63%) and microfilaria 1(1.41%). FNAC material was inadequate for opinion in 8 cases (11.28%) cases. CONCLUSION FNAC has a definite important role in the differential diagnosis of epididymal nodules as it can identify neoplastic and nonneoplastic conditions. FNAC can thus be used to segregate the group of patients requiring a surgical intervention and a biopsy

BACKGROUND The Parotid gland is the most common salivary gland to be affected by different pathological variants of swellings which present as a mass in the retromandibular area. The pathology of these lesions varies from inflammatory lesions, cysts, benign and malignant neoplasms. In our study we included only the cases which turned out to be Tuberculosis of the parotid gland. METHODS A small hospital based study of 100 cases of parotid swellings were carried out in the department of Otorhinolaryngology & Head Neck Surgery, MGM Medical College & LSK Hospital Kishanganj, Bihar, India from December 2012 to December 2015. All the cases of parotid swellings were analyzed by taking detailed history, clinical features, biochemical, microbiological, ultrasonographic & CT scan findings, and FNAC. The cases which were diagnosed as Tuberculosis of the parotid, were included in the study. Pathological variants other than tuberculosis were excluded from the study. RESULTS In our series there were 47 males (47%) and 53 females (53%), out of which 5 patients (5%) were diagnosed with tuberculosis of the parotid gland. Amongst the 5, male patients were 3(3%) & females 2(2%).

INTRODUCTION Lymph node is a common site of metastasis for various malignancies. So the strong clinical suspicion and thus the early diagnosis of palpable lymphadenopathy by FNAC is of paramount importance. It is useful to differentiate between inflammatory lesions or malignant lesion whether primary or metastatic. AIMS To establish the role of fine needle aspiration cytology (FNAC) as a diagnostic tool in the interpretation of metastatic lymphadenopathy. MATERIAL AND METHODS The present study was conducted on 295 consecutive patients presented with lymphadenopathy and were reported as metastasis. OBSERVATIONS Total of 295 cases of metastatic lymphadenopathy were taken. Squamous cell carcinoma was the most common primary tumor metastasizing to lymph nodes (n=133) followed by adenocarcinoma (n=57), duct carcinoma breast (n=22) , mucoepidermoid carcinoma (n=19), undifferentiated carcinoma (n=13), small cell carcinoma (n=11) and other malignancies Cervical lymph nodes were the most commonly involved and the commonest primary site was head and neck. In most of the cases primary could be pointed out based on clinical and cytological findings. CONCLUSION FNAC is a rapid, safe, easy and non-expensive diagnostic technique which can be used for initial diagnosis of metastatic lymphadenopathy in a resource challenged environment, confirm secondaries where primary tumor is evident, for detection of primary of unknown origin and for response to treatment.

BACKGROUND FNAC of salivary gland tumours is an accurate, simple, rapid, inexpensive, well tolerated and harmless procedure. The success of FNAC depends on the adequacy of sample and high-quality preparation. FNAC of salivary gland neoplasms provides essential information in decision making and management. AIM OF THE STUDY Know the role of fine needle aspiration cytology in the diagnosis of benign and malignant lesions of salivary gland. MATERIAL AND METHODS This was a prospective study done at the tertiary care centre for a period of three years. A total number of 67 cases of clinically suspected salivary gland tumours were subjected to fine needle aspiration cytology and correlated with histopathology. RESULTS A total number of 67 cases, clinically suspected as salivary gland tumours were subjected to FNAC and compared with histopathology. The observations of the study were as follows: Most of the tumours were observed between the age group of 31-40 years. The commonest gland involved was the parotid gland, 56 cases of benign, 10 cases of malignant and one case of inconclusive diagnosis was made on FNAC. In the present study, FNAC showed Sensitivity of 66.6%, Specificity of 98%, Positive predictive value; 90.9%, Negative predictive value; 91%, Percentage of false negative cases 33.3%, Percentage of false positive cases 1.9% and Overall Diagnostic Accuracy of 91%. CONCLUSION FNAC is a very useful, simple, cheap, accurate and repeatable technique in the preoperative diagnosis of various salivary gland neoplasms. Overall, diagnostic accuracy was 91%, in cystic lesions of salivary glands, combined FNAC and histopathology is essential for diagnosis.

Carcinoma of the breast is one of the commonest cancers occurring in female and accounts for 1/3rd of all the malignant diseases occurring in them. It is mainly a disease of the developed countries and accounts for 1,00,000 deaths annually. Breast carcinoma is classified as Early breast cancer, Locally advanced breast cancer and Metastatic breast cancer. By definition early stage breast cancer constitutes breast tumors of clinical stages I, IIa and T2N1M0. Early breast cancer is the one diagnosed by mammography. Women when approaches at this stage, they can go for breast conservation surgery. Not all women are candidates for this approach, and some require mastectomy as part of their treatment. AIM To observe the incidence of early breast carcinoma with particular reference to the time taken by the patients to seek medical advice after the symptoms have developed i.e. the average time taken by the patients to seek medical advice, their appropriate management and prognosis. MATERIALS AND METHODS This prospective study was conducted over a period of 2 years from Oct-2012 to Oct-2014 in 30 female patients aged between 25-65 years who were presented with lump in breast of size ≤5cms with or without pain, with or without lymph nodes to the outpatient department. All the patients were thoroughly asked about history, examined clinically, investigated, staged and managed by surgery either Breast Conservation Surgery or Modified Radical Mastectomy. Postoperative complications were recorded and followed up regularly. RESULTS The incidence of early breast cancer in this study was 0.98% with peak age incidence between 40-60 years and duration of symptoms

BACKGROUND Solitary Thyroid Nodules (STN) occur in 4-7% of the adult population. Owing to increasing incidence of malignancy, it is necessary to differentiate patients with benign STN from malignant ones for early intervention and better patient management. The aim of the study is to study the clinicopathological characteristics of STN for better diagnosis, evaluation and management; evaluate the efficacy of FNAC in preoperative diagnostics of solitary thyroid nodules. MATERIALS AND METHODS The study was conducted over a period of one year at a tertiary healthcare institution in South India. One hundred patients with solitary nodule of thyroid were studied by taking detailed history and conducting clinical examination, thyroid hormone assay, ultrasonogram, FNAC and histopathological examination. The chances of malignancy and age, sex and site distribution were also analysed. RESULTS Solitary thyroid nodule cases showed female preponderance (81%), presented mostly as neck swelling followed by dysphagia (11%). Most common FNAC report was of colloid nodule (61%), followed by follicular neoplasm (20%) and papillary carcinoma (9%). Final HPR showed 53% as colloid nodule and 27% as papillary carcinoma. CONCLUSION Differentiating between benign and malignant lesions and their comprehensive management are the challenges presented by STN. Fine Needle Aspiration Cytology (FNAC) is the diagnostic tool of choice for the initial evaluation of STN.

INTRODUCTION Thyroid disorders (TD) are endocrine disorders which are commonly encountered in the ENT out-patient department these days. These cases usually present with solitary neck swelling. In the present study done at Government ENT Hospital, Hyderabad we have selected 100 cases of only Solitary Thyroid Nodule (STN) over a period of 2 years from September 2013 to August 2015. AIM Aim of this study is to find out the incidence of thyroid disorders in general population which required surgical intervention, and to find out the incidence of thyroid disorders in relation to age and sex. To find out incidence of thyroid hormonal status in cases of STN and correlate the findings of FNAC, SQUASH and final HPE report of these patients. MATERIALS AND METHODS The present study has been conducted by utilizing cases admitted and managed in the Department of ENT at Govt. ENT Hospital, Hyderabad over a period of 24 months from Sept 2013 to Aug 2015. Cases presented with only Solitary nodule were included and malignancies and multinodular goiter are excluded. RESULTS Incidence of thyroid disorders in general population which requires surgical intervention is 0.11%. Peak age of incidence is between 30 to 50 years i.e. 60%. Mean age of presentation is 37 years. There is a female preponderance with M:F ratio is 1:6.14. Majority of the patients are euthyroid. The correlation between FNAC, SQUASH and HPE report is around 96%. CONCLUSION The following conclusions are: The incidence of thyroid disorders in general population is increasing and in our study shows it as 0.11%. Solitary nodule of thyroid is more common in females (86%) and the incidence is rising in males (14%) M:F 1:6.14. Solitary nodule of thyroid is more common in the age group of 20-50 years and the mean age of presentation is 37 years. Most of the solitary thyroid nodules are benign (79%) after final HPE report. Most of the patients with solitary nodule of thyroid are in euthyroid (94%) state. The correlation between FNAC and SQUASH is around 97% in our study. The correlation between SQUASH and HPE is around 98% in our study. The correlation between FNAC and HPE is around 96% in our study.

BACKGROUND: Fine - needle aspiration cytology (FNAC) of the salivary gland is a time tested, cost effective, reliable and safe technique in the diagnosis of both neoplastic and non - neoplastic lesions of the salivary gland. It also helps to eliminate confusion with lymphadenopathies as there is a lot of overlap in the clinical presentation of both saliv ary gland and lymph node swellings. Here we aim to study the incidence of common salivary gland pathologies in our set up and also attempt to analyze the role of FNAC in differentiating between sialadenopathies and lymphadenopathies. METHODS: A retrospecti ve study of 100 consecutive patients clinically diagnosed with salivary gland pathologies and referred to Cytopathology Section, Department of Pathology, CIMS, Bilaspur for FNAC was conducted from 01.04.2004 to 07.05.2010. Clinically diagnosed lymph node s wellings which subsequently evinced salivary gland cytopathology were also included in this study. The lesions were classified based on cytomorphological diagnostic criteria and different incidental parameters like age, sex, location, presenting symptoms, duration of complaints etc were calculated. RESULTS: The lesions were broadly categorized cytomorphologically into non - neoplastic salivary gland lesions (42.5%), benign neoplastic salivary gland lesions (46.25%) and malignant salivary gland lesions (11.25 %) after excluding the negative results (aspiration failure, inadequate material, non salivary cytopathology). M : F Ratio was 1.56:1 (61:39). Parotid was the most common salivary gland involved (47.5%). The most common benign salivary neoplasm was pleomorph ic adenoma (38.75%) and the most common malignant neoplasm was mucoepidermoid carcinoma (7.5%) . CONCLUSION: FNAC is a reliable, safe and simple outpatient procedure in the diagnosis of salivary gland lesions, and is also of some value in distinguishing sal ivary lesions from clinically indistinguishable non salivary swellings occurring in the same locations

BACKGROUND : Lymphadenopathy is one of the common clinical presentations of patients. It has a varied aetiology which varies from an inflammatory process to a malignant condition. Fine Needle Aspiration Cytology (FNAC) is an accurate, simple and an easy diagnostic tec hnique in evaluation of the causes of lymphadenopathy, and the reports can be made available within an hour that will form the basis of treatment, reduce the number of surgical procedures and unnecessary surgical intervention. OBJECTIVES: To study the cyto logical features in lymphadenopathy and categorize them with respect to aetiology, age, sex and site of occurrence, and to have a histopathological correlation of FNAC findings , wherever possible. METHODS: All patients referred to the Department of Patholo gy of a Tertiary hospital for FNAC of superficial and deep lymph nodes in the study period were enrolled for the study. The patients were clinically evaluated and clinical details were obtained from the medical records. FNAC was performed and their diagnos is made. The data was analysed. In 41 cases, FNAC diagnosis was correlated with histopathological diagnosis. RESULTS: Out of the total 678 cases (including 22 guided cases) only 03 aspirates were inadequate for reporting. Most of the cases were in the age group of 20 - 29 years, with a male preponderance. The most commonly involved were cervical group of nodes, with the deep - seated nodes least involved . 83.33% of cases were diagnosed as benign lymphadenopathies, most of which were reactive lymphadenitis (50. 44%). ZN stain for AFB was positive in 24.49% of cases with suspected tuberculosis. Maximum number of positive cases (56.75%) was found, when purulent material was aspirated. Metastatic deposits were seen in 12.68% of cases. Most common subtype was poorly differentiated carcinoma.17 cases were diagnosed as Lymphomas, of which 10 were Hodgkin’s lymphoma and 7 were Non - Hodgkin’s. Histopathological data was available for 41 cases. 38 cases correlated well with FNAC. There was good correlation between FNAC and histopathology with an overall agreement of 92.7% (38 out of 41). Considering histopathology as gold standard, specificity of FNAC was 92.7%. CONCLUSION: Fine Needle Aspiration Cytology (FNAC) is an accurate diagnostic technique in diagnosing aetiology of lymphadenopathies which is one of the commonest clinical presentations of patients attending a health care centre and which can have an inflammatory to a neoplastic aetiology. FNAC provides a speedy diagnosis which will help the clinician to confirm or exc lude the clinical differential diagnosis made at first visit of the patient and helps him to further plan the treatment. With the advent of ultrasound and computerized tomographic machines, the evaluation of deep - seated lymph nodes has also become possible through Guided FNAC’s

INTRODUCTION : Fine Needle Aspiration Cytology is well established technique for evaluation of epithelial tumors for many years. Now it has gained its reputation in the diagnostic work up of soft tissue tumors as well. In o ur study we assessed a total of 252 cases of soft tissue tumors by Fine Needle aspiration cytology during a period of two years 2009 - 2011 and the patients were followed up for biopsies for histopathological correlation. The initial diagnosis of many mass lesions, both superficial and deep - seated, can often be readily and safely assessed by FNAC. AIMS AND OBJECTIVES: 1. To study the age, sex and site - wise distribution of soft tissue tumors. 2. To assess the role of Fine Needle Aspiration Cytology in diagnos ing various types of soft tissue tumors. 3. To assess the sensitivity, specificity, positive and negative predictive values, and overall histological correlation percentage of Fine Needle Aspiration Cytology in diagnosing soft tissue tumors. MATERIALS AND METHODS: Aspirations were done using a 22 gauge disposable needle and a 10c.c disposable syringe for suction. Wet - fixed smears with isopropyl alcohol were stained with hematoxylin and eosin. Dry - fixed smears were stained with May - Grunwald Giemsa were stud ied for cytological details and diagnosis. The excised surgical specimen and biopsies of the above cases were processed routinely and stained with Hematoxylin and Eosin. RESULTS: Total 252 cases were studied from Aug 2009 to July 2011 retrospectively. Out of these we received excised specimen and biopsies for 216 cases. Rema i ning 36 cases were excluded in our study as we could not trace the patient for biopsies. 180 were diagnosed as benign soft tissue tumors, while 36 were diagnosed as malignant on cytolog ical examination. The median age of benign soft tissue tumors was 35 years, while that of malignant soft tissue tumors was 40years. Prevalence was highest in the age group of 21 - 40 years, during which majority were benign lesions. Soft tissue tumors were m ore common in the lower extremities with predominant benign tumors, while malignant tumors were more common in the trunk. Sex wise distribution showed a male: female ratio of 1.18:1, indicating that they were more common in males. The most common tumors we re lipomas, followed by Hemangiomas and peripheral nerve sheath tumors. A comparative analysis was done between the cytology report and histopathology. CONCLUSION: Final evaluation of the results showed that the diagnostic accuracy of FNAC of soft tissue t umors according to the present study was 95.37%, sensitivity was 84.2% and specificity 97.75%. Thus our study proves the efficacy of FNAC in the diagnosis of soft tissue tumors as a useful cost - effective procedure

BACKGROUND: Lymphadenopathy is common in HIV infected individuals as lymphoid tissue is a major target and reservoir of the Human immunodeficiency virus (HIV) as well for opportunistic infections. AIM : Clinical assessment of HIV positive patients with lymphadenopathy and its correlation with lymph node fine needle aspiration cytology (FNAC) and CD4 count. STUDY DESIGN: Cross sectional study of 100 HIV positive patients. MATERIALS AND METHODS: Clinical profile of 100 HIV positive patients with lymphadenopathy was taken. FNAC of the largest lymph node was done. Smears collected were stained by different staining techniques like papanicolou staining, H& E staining, G iemsa staining and AFB as well as PAS staining. FNAC finding was compared with the CD4 count. RESULTS: Of the 100 patients studied, maximum number of cases was reported in the age group of 31 to 40 years. Majority of the patients were males (81%). Most common presentations were fever in 71%, weakness in 71%, weight loss in 53% and lymph node swelling in 23% of patients. Most common site of lymph node i nvolvement was cervical. FNAC of lymph nodes revealed that maximum number of cases had tuberculosis lymphadenitis (59%), followed by reactive hyperplasia (37%), non - Hodgkin's lymphoma (2%), cryptococcosis (1%) and metastasis (1%). The mean value of CD4coun t was 461 for reactive hyperplasia, 294 for TB lymphadenitis, and 318 for others. Multiple comparisons of FNAC with CD4 count, revealed significant p - value between Tubercular lymphadenitis and Reactive hyperplasia. CONCLUSION: Low CD4 count is associated w ith Tubercular lymphadenitis and higher CD4count with Reactive hyperplasia.

BACKGROUND AND OBJECTIVES The breast is the essential symbol of womanhood to society and to the woman herself. Subjected every month to the onslaught of ovarian, adrenal, pituitary and thyroid hormones in tandem with the uterus, the very histological architecture of the breast changes sequentially. With the recent importance given to early diagnosis of cancer of the breast and its early detection by both the patient and her physician, more benign conditions are likely to be detected than earlier. The objective of our review is to find out the incidence of benign breast lump above 40 years of age in females attending our hospital. METHODS AND MATERIALS 130 patients presenting to the outpatient department of KAPV Medical College with breast lump were included in this comprehensive study. A detailed history regarding the duration and nature of the complaints, family history pertaining to breast or ovarian cancers, risk factors such as oral contraceptive use, parity, lactation, etc. was elicited. A thorough clinical examination was performed. RESULTS Of 24 cases of fibroadenoma, all were operated upon by excision. Of 38 patients with fibroadenosis, 30 patients managed conservatively and surgery for 8 patients where the diagnosis was doubtful. Abscesses were incised and drained under antibiotic cover for 3 patients. 8 cases of breast cyst were managed by aspiration. TB mastitis was confirmed by excisional biopsy and followed up by antituberculous therapy with regular follow up after 6 months. Healed lesions were found to be associated with improved general condition of the patients. Lipoma and sebaceous cyst were managed by excision biopsy. CONCLUSION Benign breast diseases were found to be common in woman above 40 years old in contrast to normal teaching, which says they are common in younger age groups. Fibroadenosis was the commonest benign disease closely followed by fibroadenoma. Fibroadenosis was mostly managed conservatively. Excision biopsy was done for fibroadenoma, lipoma and fat necrosis.

BACKGROUND Fine-Needle Aspiration Cytology (FNAC) is a widely used method, which is accurate and safe in a readily palpable masses. But, in those inaccessible lesions and deeper organs are safely aspirated using fine needle radiological procedure like ultrasound or computed tomography guided. The aim of the study is to assess the utility of FNAC in the diagnosis of intra-abdominal lesions and different pattern of lesions in particular to the sites. MATERIALS AND METHODS This retrospective study was done in the Department of Pathology, Regional Institute of Medical Sciences (RIMS), Imphal, between June 2010 and June 2016. The study included 128 intra-abdominal masses. Giemsa and Papanicolaou’s stains were used. The cytological diagnosis was correlated with clinical and radiological data to arrive at a final diagnosis. RESULTS Reports on FNAC smears were retrospectively analysed, which had been done in various anatomic sites- liver (70 cases), colon (19 cases), gallbladder (17 cases), mesenteric lymph nodes (12 cases), ovary (3 cases), adrenals (2 cases) and 1 case each of pancreas, peritoneal wall, pelvic, suprapubic and flank masses. The mean age was 42.16 years with M:F of 1.3:1. The diagnostic yield was 85.2% in combination for Ultrasound Guided (USG) and Computed Tomography (CT) guided aspiration. The smears were classified as benign neoplastic, malignant neoplastic, non-neoplastic, inconclusive and unsatisfactory for interpretation. There were 79 (61.7%) malignant neoplastic lesion, 5 (3.9%) benign neoplastic lesion, 25 (19.5%) non-neoplastic lesion, one (0.7%) inconclusive lesions and 18 (14.1%) unsatisfactory smears. The liver and the colon were the most common sites. Adenocarcinomas and Hepatocellular Carcinoma (HCC) were the most common malignant lesions comprising of 35 (44.3%) and 25 (31.6%) of the total malignant lesions diagnosed. CONCLUSION Intra-abdominal FNA is a simple, economical and a safe procedure with high sensitivity, specificity and diagnostic accuracy and it can be utilised as a preoperative procedure for the management of intra-abdominal lesions.

BACKGROUND : Fine needle aspiration cytology (FNAC) is a safe, faster, cost - effective and accurate diagnostic procedure that investigates superficial lumps. It is also a useful technique in diagnosing etiology of lymphadeniti s. MATERIALS AND METHOD S: The present study was conducted to identify utility of FNAC to study the pattern of pathological conditions detected in lymph nodal swellings of head and neck region among 50 patients belonging to all age groups and both sexes reporting at a tertiary care hospital in rural set - up. RESULTS: The cytological finding were correlated with age and sex distribution of the lesions, and cytological diagnosis revealed that tuberculous lymphadenitis was the most common lesion (50%), followed by reactive lymphadenitis (28%) & suppurative lymphadenitis (12%). Histopathological correlation of FNAC lesions of 8 cases was reported. CONCLUSION: The study confirms that FNAC is an accurate, cost effective, and rapid investigative procedure to diagnose lymph nodal swellings of head and neck region with minimal trauma and low complication rate

Neck swellings are common problems in our clinical practice. Neck swellings may be classified as congenital and acquired. Acquired may be inflammatory , neoplastic or others. In children the common neck swellings are congenital and inflammatory. I n adults neoplastic lesions are more important. Tuberculous lymphadenitis is one of the common causes of neck swellings in our I ndi a n population. The study was conducted at government general hospital, K akinada during the study period J uly 2014 A ugust 2015. Total 50 patients who presented with neck swellings other than thyroid were included in this study

Myeloma is a malignancy of terminally differentiated B cells (plasma cells) that produce a complete and / or partial monoclonal immunoglobulin protein. Myeloma accounts for approximately 1% of all malignancies and 10% of haematological tumors. It becomes difficult to arrive at early diagnosis because myeloma manifests itself in different forms. The disease usually presents as bone pains, pathological fractures and anemia but can also present as swelling in jaw, orbit, rib, sternoclavicular area, scalp, paraspinal region and tonsil. We present a case of multiple myeloma in 63 year old male which presented as a soft tissue mass on anterior chest wall and diagnosed by FNAC . This case is presented because diagnosis was made on cytology and not many cases have been reported in literature where FNAC helped in making the diagnosis. This increases the hope of early diagnosis so that treatment can be advocated

Lymphangiomas are fluid-filled thin-walled cysts formed due to malformations in the lymphatic system. It is usually seen in children and is rarely present in adults. Majority of the cases of lymphangiomas are seen in head and neck region with occasional extension in mediastinum. We present a case of an adult with macrocystic lymphangioma in the left posterior triangle of neck. FNAC and MRI are important modalities of investigation for diagnosis of lymphangioma. Surgical excision is the main modality of treatment in case of macrocystic lymphangioma. In case of a soft cystic swelling in head & neck region, a differential diagnosis of lymphangioma should be kept in mind.