European Journal of Cardiovascular Medicine

Introduction- Primary lung epithelial malignancies are the most common neoplasms among all lung masses. Lung carcinoma is the leading cause of death for which a histological or cytological confirmation and categorization of malignancy is required before treatment. It is desirable to have both FNAC or TBNA and biopsy for exact diagnosis. Sometimes, even immunohistochemistry is required to confirm the diagnosis.

Background: Fine needle aspiration cytology is a simple, quick and inexpensive method that is used to sample palpable lymph nodes. Objective: To study the role of FNAC in the evaluation of lymphadenopathies. To categorize various lymph node lesions into neoplastic and non-neoplastic lesions. To study the various cytomorphological patterns in correlation with histopathology of various lymph node lesions. To evaluate the sensitivity and specificity of FNAC using histopathology as gold standard. Material and Methods: All patients referred to the Department of Pathology, Dr VRK Womens Medical College and Research centre. RR District, Telangana. for FNAC of palpable lymph node were included in our study. FNAC was done and the standard method for the procedure adopted. All the slides were reviewed and their diagnosis was made. FNAC diagnosis was compared with histopathology in cases which underwent surgical excision and thus it's diagnostic accuracy determined. This was two years prospective study from Jan-2015 to Dec-2016. Results: A total of 150 patients were included in our study, reported to various clinical departments with history of swelling. Lymph node biopsy was done in 55 cases. Statistical analysis was done in 55 cases, where FNAC diagnosis was correlated well with histopathological diagnosis. Maximum number of cases were in the age group of 21-40 years. Our study showed female preponderance of cases. Cervical group of nodes were most commonly involved. Benign lymphadenopathies were diagnosed in 72.67% of cases. Maximum number of cases being granulomatous lymphadenitis (50.46%). Metastatic deposit was diagnosed in 23.33% of cases. Most common subtype being adenocarcinoma (54.3%). Lymphoma were diagnosed in 06 cases (4%). The overall correlation between FNAC and histopathology was 98% (54 out of 55). Conclusion: FNAC is an accurate, sensitive, specific and cost-effective procedure in the diagnosis of lymphadenopathies

Introduction: Breast carcinoma is found to be the leading cancer in women, both in developed and developing countries across the world. Though breast cancer is thought to be a disease of developed countries, 50% of the cases and 58% of the deaths occur in developing countries. It is found to have increased in developing countries due to lack of awareness and its later stages detection. Detection of cancer in early stage can improve the survival chances of the patient, and cancer control can be achieved. Aims: The objective of my study is to find accuracy of FNAC in diagnosis of breast malignant masses and to correlate the benign and malignant FNAC feathers with ultrasound diagnosis for early detection of Breast Carcinoma.  Screening of the breast lesion using ultrasonography followed by FNAC of the lesion will help early detection and treatment of the disease. Materials and Methods: The study was prospective, cross sectional and hospital-based on 100 female patients of age ranging between 15-85 years with history of palpable breast masses referred to Radiological Department of DMCH for USG scan independently and in combination with FNAC correlation in the Department of Pathology of DMCH. Result: Out of the total 62 breast lump examined, 42 (67.74%) breast lumps were reported as benign and 19 (30.65%) were reported as malignant. In one case the result was indeterminate as the cytopathologist reported as “papillary lesion”. The final histopathological result, however, turned out to be “ductal carcinoma in situ with solid, cribriform and micropapillary patterns”. Conclusion: A breast tumour must be evaluated to rule out cancer. FNAC is a tissue diagnostic method, while ultrasonography is an imaging approach. In our research, the specificity of both diagnostic instruments in identifying malignant breast lump was found to be 100%, implying that a positive (malignant) result of either test can exclusively determine the treatment choice without further diagnostic inquiry.

Background: Detection of smaller thyroid nodules has significantly increased because of the advent of high-resolution ultrasonography. Therefore, accurate characterization of these nodules has gained importance to avoid unnecessary FNACs and biopsies. Aim: To evaluate role of elastography as an adjunctive tool to TIRADS categories in differentiating benign from malignant thyroid nodules with cytological correlation. Methods: 47 patients with diagnosed thyroid nodules were enrolled. USG was done by two independent observers and TIRADS characterization was done. Following this Shear Wave elastography was done for all these nodules and nodules were characterized as benign or malignant. FNAC for cytological correlation was done. Results: TIRADS alone has a sensitivity of 91.67% and specificity of 91.7%, positive predictive value of 93.3% and negative predictive value of 73.3%. When combined with elastography the sensitivity becomes 77.7% and specificity becomes 93.7%, positive predictive value of 93.3% and negative predictive value of 73.3%. Conclusion: Combined efficacy of elastography with ultrasound estimated TIRADS score increases the diagnostic confidence to label malignant vs benign nodule significantly and thus has potential use to reduce unnecessary FNACs.

Background:  Tuberculosis is a specific infectious disease caused by bacteria belonging to the "Mycobacterium tuberculosis complex". It presents a great social and economic problem and is one of the major factors responsible for high morbidity and mortality in India. The incidence of tuberculous cervical lymphadenopathy accounts for two third of extra pulmonary tuberculous lymphadenopathy. Higher proportion of tuberculous origin is because of greater incidence of pulmonary tuberculosis in our country. Perhaps there are many other causes of lymphadenopathy which are usually misdiagnosed as tuberculosis. Thus, it has been a common problem for both the clinicians as well as the pathologists to diagnose tuberculosis. Methods and Materials: The present work is carried out in 100 clinically suspected cases of tuberculous cervical lymphadenitis attending E.N.T., Surgery, Paediatrics and Medicine Department of central India institute as an outdoor/indoor patient during the period of one year. Patients with enlarged cervical lymph nodes with a history suggestive of tuberculosis were included after taking an informed consent. Results: Study was conducted on 100 clinically suspected cases of tuberculous cervical lymphadenitis, Tuberculosis was diagnosed in 57% cases by FNAC, smear and culture together, the maximum incidence of tuberculosis was observed in second and third decades, Females were more affected (64%) than males with the ratio of 1:2.3. FNAC showed accuracy of 42%, 30% cases were AFB smear positive in our study which nearly matches to other authors. The culture studies could diagnose 57 cases as tuberculous and 4 cases as non-tuberculous cervical lymphadenitis. Culture positive was higher in granulomatous necrotic lesions. Sensitivity, specificity and predictive values of culture study were significantly higher than FNAC and smear. These methods of investigation require considerable experience and confidence of the pathologist who perform the procedure for better results. When culture was taken as Gold Standard, cytology was found to be more sensitive than smear. Conclusions: From this study we concluded that Both FNAC and smear are quick, simple, less traumatic and cost-effective methods and are used as routine investigating procedures in OPDs of urban and semi-urban hospitals. Simplicity of these techniques (FNAC & Smear) combined with early availability of results and good diagnostic accuracy warrants their clinical application. Missed cytological diagnosis and isolation of non-tuberculous mycobacteria justify the use of culture studies in all suspected tuberculous lymphadenitis cases.

Background and Objectives: Chronic lymphocytic thyroiditis is autoimmune thyroiditis; it is considered as second most common thyroid disorder diagnosed on FNAC following colloid goitre. FNAC is a reliable and efficient method for diagnosing these thyroid lesions. Chronic Lymphocytic thyroiditis frequently affects women, primarily compared to men and is commonly found with hypothyroidism, euthyroidism or every so often with hyperthyroidism. The incidence rate of Hashimoto’s thyroiditis is 1–4%, with an occurrence of 30–60/100000 population per year. Autoimmune thyroiditis can be categorized on the cytomorphological features of FNAC. Methods: To compare FNAC cytological findings with TFT in Chronic lymphocytic thyroiditis. One hundred ten patients with thyroid swellings were presented for FNAC examination, serology of TFT and Anti TPO antibodies and Ultrasonography during 2020–2021. In addition, fine needle aspiration cytology was performed using non-aspiration or aspiration techniques. TFT and Anti- TPO antibodies were performed on Avion CLX 120 auto analyser based on the Chemiluminescence method. Result: Out of 110 cases of midline neck swelling presented in our department, Autoimmune Thyroiditis was observed in 43 cases. The most affected age group of lymphocytic thyroiditis was 21–30 years, with the male: female ratio being 1:3. Most of the patients presented with diffuse swelling and few presented with nodular swelling. The Grading of the lymphocytic thyroiditis was done by the criteria used by Bhatia et al Anti-TPO antibody was elevated in 19 cases (26.2%), and TSH was elevated in 28 cases (40.81%). These cases were diagnosed as autoimmune thyroiditis on cytology, clinically and also correlating with radiological findings. Grade 3 lymphoid infiltrate was seen in 53.33% (16/30) cases, and Grade 2, lymphoid infiltrate was seen in eight cases (62.50%). Grade 1 lymphoid infiltrate was seen in five cases (11.63%). Among 43 cases, 28 cases (65.12%) show hypothyroidism, 7 cases (16.28%) show hyper, and 8 cases (18.60%) show Euthyroidism. Among these 43 cases, 26 cases showed diffuse thyroid swelling on ultrasonography, and 7 cases showed solitary nodule. Conclusion: Grade 3 lymphocytic infiltration statistically correlates with anti-TPO and TSH in conjunction with ultrasonography findings of diffuse enlargement of the thyroid gland. The presence of Hurthle cell change, giant cells, anisonucleosus, and granulomas do not find to be any statistical correlation with lymphocytic thyroiditis as these cases are primarily corresponding to Grade 1 and Grade 2. Through this study, we conclude that FNAC remains the gold standard method despite having different diagnostic modalities accessible for diagnosing thyroid lesions. Grading of FNAC Smears depends on lymphocytic infiltration of the thyroid follicles, along with positivity for antithyroid antibodies (anti-TPO antibody) and TSH. These findings are firmly associated with Chronic Lymphocytic Thyroiditis.

Fine needle aspiration cytology (FNAC) has been established as the most preferable first line investigation for palpable breast lumps. Incidence of both benign and malignant breast lesions has been increasing in India in the recent times. Various predisposing factors have been attributed for the rapid surge of breast lesions. Materials & Methods: This study was carried out in the Department of Pathology, in the newly established Government Medical College and Hospital, Rajamahendravaram, Andhra Pradesh. A Total of 57 female patients presenting with palpable breast lump were subjected to FNAC procedure after taking history and doing general and local examination. Smears were prepared, stained and cytological diagnosis was made and reporting done by IAC (International Academy of Cytology), categories C1 to C5. Results: Most of the female patients presenting with palpable breast lump were in the age group of 31-40 years. The most common lesion diagnosed was Fibroadenoma. Malignancies formed 19.29% of all cases. Most of the lesions (71.95%) were in C2 category of IAC. Conclusion: FNAC is a fast and easily available technique to diagnose and differentiate between various benign and malignant breast lesions. It also guides the clinician for proper preoperative evaluation of patients.

Background- Cervical Lymphadenopathy is a common problem in children and it is considered significant if the diameter exceeds 1 cm for cervical and 1.5 cm for axillary lymph node. Common pathology is infective and mostly benign and self limiting.

Objective- To study the clinicopathological profile of significant cervical lymphadenopathy in age group 1 month to 12 year

Methodology- This is a prospective observational study of 75 patients with significant cervical lymphadenopathy. This study was conducted at Department Of Paediatrics & Neonatology, RIMS, Ranchi, Jharkhand from April 2018 to March 2019. History, clinical examination, Mantoux test,  Hemogram, Fine Needle Aspiration Cytology (FNAC) were performed in maximum cases. USG and CT were done in some cases.

Result- Out of 75 cases, cervical lymphadenopathy was maximum in 4 to 8 years  (42.7%), 8 to 12 years (36%), and least in 1 month to 4 years (21.3%). Neck swelling (89.3%), fever (90.7%), cough (50.7%), loss of weight (26.7%), and ear discharge ( 10.7%). Most common site of cervical lymphadenopathy was cervical and least was in occipital. Lymph node consistency was firm ( 89.4%), soft (93%) and rubbery (1.3%). Associated findings were tonsillitis and/or pharyngitis, hepatosplenomegaly.

Conclusion- Lymphadenopathy is a sign of many underlying disorders and mostly benign. Few are serious which should be ruled out through examination . FNAC should be done in doubtful cases. Reactive Lymphadenitis due to bacterial or viral pathogens were the most common cause.

Material & Methods: Study Design: Prospective hospital based observational study. Study area:  The study was carried out in the Department of General surgery, B.J Government Medical College and Sassoon general Hospital, Pune. Study Period:  1 year. Sample size: study consisted of 55 subjects. Sampling method: Simple random Sampling Technique. Study tools and Data collection procedure: The following protocol was followed • Clinically and radiologically (by Mammography) suspected cases of locally advanced Ca breast were enrolled for the study after informed written consent. • Histopathological diagnosis was made by FNAC. • In the cases where FNAC was not conclusive, tru-cut biopsy was done • Once histopathological diagnosis was confirmed estrogen and progesterone receptor status was found out by immunohistochemistry. • Clinical stage IIIa and IIIb i.e locally advanced breast cancer (LABC) patients were considered for the further study (total number of patients was 55). Results: A total of 18 (29%) patients had clinical complete response (CCR) of these 16 patients, only 10 patients (62.5%) had a correlating pathological complete response (pCR). In our study. 53 (90-4%) patients had an infiltrating ductal carcinoma while 2 had infiltrating lobular carcinoma. Majority (94 29%) of the patients had an infiltrating ductal carcinoma. Conclusion: The current study reveals that clinical assessment of response to NACT has higher sensitivity than radiological assessment, but the overall poor sensitivity and specificity rates of clinical assessment need the search for a better way of evaluation.

Background: Hematological and inflammatory markers play a crucial role in assessing and differentiating between granulomatous and non-granulomatous lymphadenitis. Lymphadenitis refers to the inflammation of lymph nodes, and it can be categorized based on the presence or absence of granulomas. Granulomatous lymphadenitis is characterized by the formation of granulomas, which are aggregates of immune cells, particularly macrophages, that are surrounded by lymphocytes. Non-granulomatous lymphadenitis, on the other hand, lacks the formation of granulomas. Inflammatory markers play a crucial role in assessing and distinguishing between granulomatous and non-granulomatous lymphadenitis. These markers are substances in the blood that are elevated in response to inflammation. Here's an overview of the role of inflammatory markers in these two types of lymphadenitis. Materials and methods: This is a prospective study was conducted in the Department of Pathology, Tertiary Care Teaching Hospital over a period of 1 year. The study included 160 patients sample neck mass cases. Research participants were categorized as granulomatous and reactive lymphadenitis according to their cytological report. Samples were collected in tubes containing ethylenediaminetetraacetic acid and analyzed by automated blood count according to hospital procedures. An automated hematological analyzer was used to measure hematological parameters. We studied parameters such as TLC(Total leucocyte count), DLC(Differential Leucocyte Count), NLR(Neutrophil Lymphocyte Ratio), PLR(Platelet Lymphocyte Ratio). CRP was measured on a semi-automated analyzer 300, and ESR by the Westergren method. Result: In our study, out of a total of 160 cases, 80 were classified as granulomatous and 80 cases as reactive lymphadenitis. In the studied population, there were 64.5% females and 35.5% males. In our study found a female preponderance in both study groups as indicated. The average age of the study group was 29.59±0.95 in granulomatous lymphadenitis and 28.36±18.65 in non-granulomatous. All laboratory parameters in the two groups of lymphadenitis are shown in Table 4 indicating differences in their mean values. Hematological parameters such as NLR, PLR and CRP were significantly increased in patients of granulomatous disease and showed statistical significance with disease severity (P<0.001) where as other parameters such as TLC, ESR was not significant. Conclusion: Hematological and biochemical parameters like NLR, PLR, and CRP can give us some indication before FNAC for the presence of granulomatous and non-granulomatous lymphadenitis. It will help the treating doctor think methodically about early case identification and avoid diagnostic delays in situations like tuberculosis, especially at the primary care level.

Introduction: Palpable breast swelling, whether benign or malignant, results from hormonal influences. Most cases are benign. Triple assessment—clinical, histological, and radiological—enables accurate detection and evaluation, guiding effective interventions. The research aimed to compare the patterns of breast swelling in premenopausal and postmenopausal women and identify the most common breast lumps in each group. Methods: One hundred female patients with palpable breast lumps were evenly divided into premenopausal (50 patients) and postmenopausal groups (50 patients). Each patient underwent clinical examination, fine-needle aspiration cytology (FNAC), and core needle biopsy if necessary. Ultrasonography (USG) of the breast was conducted for all patients, and mammograms were performed for selected cases. All postoperative specimens underwent histopathological examination. Results: Among the total 100 patients, 60 were diagnosed with benign breast disease, and 40 had malignant breast disease. In premenopausal women, 82% were diagnosed with benign disease, while in postmenopausal women, 38% had a benign diagnosis. Conversely, premenopausal women showed an 18% incidence of malignant breast disease, while postmenopausal women exhibited a 62% incidence. Among malignant breast diseases, 60% were invasive ductal carcinoma, 32.5% were invasive lobular carcinoma, 5% were invasive medullary carcinoma, and 2.5% were inflammatory carcinoma. Conclusion: The study finds a higher prevalence of malignant breast disease in postmenopausal women, while premenopausal women commonly experience benign breast disease, notably fibrocystic cystic disease. Premenopausal women exhibit a higher percentage of invasive lobular carcinoma than the general population, while postmenopausal women predominantly face invasive ductal carcinoma breast NST/NOS with increased invasive lobular carcinoma.

Introduction: FNAC has a pivotal role in the evaluation of breast lesions. Cytological grading systems are being utilized for the categorization of breast lesions. Modified Masood’s scoring System (MMSS) is used to improve the grading system for accurate pre-operative diagnosis. This study aims to assess the effectiveness and accuracy of the Modified Masood Scoring System for evaluating breast lesions and their correlation with histopathological diagnosis. Materials and Methods: This is a prospective study conducted in the Department of Pathology, MGM Medical College, Navi Mumbai which included 40 patients who presented with clinically palpable breast lump and were subjected to FNAC along with histopathological examination. The cytological smears were grouped into four categories according to MMSS. Correlation and concordance analysis between cytological categories and histopathological diagnosis was carried out. Observations and Results: The age of the patients ranged from 17 to 70 years with a mean age of 38.12 years, right-sided breast lesions were more common as compared to the left side. Of the total 40 cases, 27 cases were benign, and 13 cases were malignant on histopathology. The most common benign breast lesion was Fibroadenoma [Figure 1] and the malignant lesion was infiltrating duct carcinoma [Figure 2]. The sensitivity, specificity, Positive predictive value, Negative predictive value, and diagnostic accuracy were 76.9%, 100%, 100%, 90%, and 92.5% respectively. Conclusion: MMSS is simple, cost-effective, easily reproducible, reliable, and can be applied to FNAC aspirates to increase the diagnostic accuracy of Breast Lesions

Background: Lung cancer is one of the most frequent cancers and a major cause of cancer death worldwide. Lung cancer accounts for 11.6% of all new cancer cases identified each year and is quickly becoming the most prevalent fatal neoplastic disorder in the world, accounting for 18.4% of all cancer-related fatalities worldwide1. Objectives: 1. To study the clinical profile of newly diagnosed bronchogenic carcinoma patients. 2. To study the clinicopathological correlation among various histological types of bronchogenic carcinoma in the above patients. 3. To study the extrapulmonary manifestations and the prevalence of identifiable paraneoplastic syndromes (if present) in patients with bronchogenic carcinoma. MATERIAL & METHODS: Study Design: Prospective hospital-based observational study. Study area:  The study was conducted in the Department of Pulmonary Medicine, Government Medical College, Kadapa.  Study Period:  June 2023 – December 2023. Sample size: The study consisted of 52 subjects. Sampling method: Simple random Sampling Technique. Inclusion criteria: Patients attending hospital, diagnosed with bronchogenic carcinoma in the specified period. Study tools and Data collection procedure: Patients included in the study were selected according to the inclusion and exclusion criteria. After obtaining informed consent, data was gathered from history, objective examination of the patients and lab investigations using a semi-structured questionnaire. The localisation of the tumors was done by chest x-ray, fibre optic bronchoscopy and/or CT scan as required. Tissue diagnosis was obtained by FNAC/ biopsy or other cytology and histopathological examination of the specimen was carried out. The type pattern of paraneoplastic syndromes was noted. Results: COPD (65.38%) and Diabetes (23%) were the common co-morbidities affecting the study population followed by HTN (19.2%). H/O old PTB was noted in 11.5% of the patients and 1 patient (1.9%) had h/o ILD. 2(3.8%) patients had past h/o malignancy. One patient had h/o squamous cell carcinoma of the right ear another patient had cervical cancer and 1 (3.8%) patient had a family history of malignancy (first-degree relative). Conclusion: Lung cancer is a rapidly progressive disease with a very high mortality rate but treatment in the early stage may give a good prognosis. High-risk patients with having smoking history should be evaluated clinic radiologically with high suspicion so that early diagnosis can be made and the quality of life of patients can be improved. Primary lung cancer should always be suspected in a person presenting with unexplained cough for several weeks with other symptoms such as weight loss, and fever with non-resolving collapse-consolidation on chest radiograph.

Introduction: Thyroid Imaging Reporting and Data System (TIRADS) categorizes thyroid nodules based on ultrasound characteristics that are associated with malignancy, aiding in clinical decision-making and helping to determine when FNAC is necessary. Present study was aimed to study High-Frequency Ultrasound (HFU) in evaluating thyroid nodules. Material and Methods: Present study was Observational Cross-Sectional study, conducted in patients of any age and gender with primary thyroid-related complaints, underwent ultrasonography of the thyroid gland. Based on these ultrasound features, the thyroid nodules were stratified into the appropriate Thyroid Imaging Reporting and Data System (TIRADS) categories.  Results: The present study has been undertaken in 100 patients presented with primary thyroid related complaints. Sonographic features such as a taller-than-wide shape, irregular margins, microlobulated margins, microcalcification, and marked hypoechogenic city are associated with an increased risk of thyroid malignancy. TIRADS category 3 nodules present a 0% risk of malignancy, while TIRADS category 5 nodules have a 100% risk of malignancy, indicating an increasing risk from TIRADS category 3 to TIRADS category 5. By categorizing nodules according to TIRADS, highly suspicious nodules (categories 4 and 5) can be promptly sampled with FNAC or managed surgically, while category 3 nodules should be monitored with follow-ups. Lesions categorized as TIRADS 2 do not require further investigation.  Conclusion: High-Frequency ultrasound is a reliable method for assessing the morphology of thyroid nodules. Using a standardized lexicon and categorizing findings according to TIRADS, improves the accuracy of identifying malignant lesions.

Background: Subacute thyroiditis, also known as De-Quervain’s thyroiditis (DT), is a rare condition with an incidence of 4.9 cases per 100,000/ year. The usual work-up includes history-taking, neck examination, thyroid function test, ultrasonography (USG) of the thyroid gland, and a fine-needle aspiration cytology (FNAC). They often show nodules on examination which may appear neoplastic, thus warranting an intensive surgical treatment. This is a self-limiting condition, often with a preceding history of fever or infection.  Case Details A total of 656 cases of thyroid lesions were observed over a period of 24 months among which 14 cases of DT were diagnosed on FNAC. Females outnumbered the males with a ratio of 3.6:1. All the patients complained of painful thyromegaly. On USG, 10 cases (71.4%) showed hypoechoic nodules with ill-defined margins and 4 cases (28.6%) showed diffuse geographical areas. Six patients showed increased vascularity peripherally. Eleven patients were hyperthyroid, 2 patients were hypothyroid and 1 patient was euthyroid. Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP) were elevated in 6 cases (42.8%). FNAC in all showed granulomatous inflammation along with multinucleated giant cells engulfing colloid. Ten patients were followed up over 6 months among which 8 patients had disappearance of pain and nodules while another 2 were hypothyroid after 6 months. Conclusion DT may appear dangerously neoplastic at presentation but resolves spontaneously or with anti-inflammatory medication. FNAC helps in precise diagnosis and prevent surgical intervention.  

Background: Numerous diseases, from benign to malignant, with slow evolving or exceedingly aggressive clinical course, have been related to thyroid lesions. Disorders affecting the thyroid gland can vary from a single, isolated lesion to a systemic condition including the development of a tumor.Aim: To classify the cytomorphology of thyroid lesions by FNAC and to determine its correlation with thyroid hormone profile and radiology. Material and methods: The current study was conducted in Department of Pathology at newly started Government Medical College, Udhampur over a period of 01 year and a total of 73  patients presenting with thyroid lesions were clinically examined. SPSS (Statistical Package for the Social Sciences, SPSS Inc., v.16) was used to do the statistical analysis. For quantitative data, the descriptive statistics were computed as mean and standard deviation, and for qualitative data, as frequency and percentage. Using chi-square analysis, the relationship between two category variables was determined. For the current investigation, a P value of less than 0.05 was designated as the significance level. Results: In our study there was female predominance. Euthyroid patients represented the majority of the patient population (50.7%), followed by hypothyroid patients (28.8%) and hyperthyroid patients (20.5%). The individuals' thyroid hormonal profile  and radiodiagnosis were statistically significantly correlated. Conclusion: It is concluded that one essential diagnostic method of thyroid lesions is FNAC which can help in determining the type and nature of thyroid lesions.

Background: Benign breast diseases (BBDs) encompass a diverse range of lesions that can present with various clinical symptoms or remain asymptomatic. These conditions are more common in young women, particularly during the reproductive years, with a decreasing prevalence in older age groups. Accurate diagnosis requires clinical assessment, imaging, and cytological/histopathological correlation. Methods: This observational study was conducted over six months at a tertiary care center and included 100 female patients diagnosed with benign breast diseases. All patients underwent clinical examination, fine-needle aspiration cytology (FNAC), and, where necessary, histopathological examination (HPE) for confirmation. Data were analyzed using SPSS software to determine diagnostic accuracy and correlation between cytological and histopathological findings. Results: The majority of cases (60%) were in the 21-30 years age group, followed by 22% in the 31-40 years group. The most common clinical presentation was a painless, mobile breast lump (68%), followed by a lump with pain (24%). Fibroadenoma (58%) was the most frequently diagnosed lesion, followed by fibrocystic disease (13%) and proliferative breast disease (12%). Cytological diagnoses closely correlated with histopathological findings, with minimal discrepancies primarily in differentiating fibroadenoma from fibrocystic disease and intraductal papilloma. Conclusion: Benign breast diseases predominantly affect young women, with fibroadenoma being the most common lesion. The majority of cases present with a painless breast lump, and FNAC serves as a reliable diagnostic tool. However, histopathology remains essential for confirming certain cases. Early diagnosis and appropriate management can help alleviate patient concerns and improve clinical outcomes

Background: Face being the most exposed, area of body ,present early to clinician for getting evaluated. As FNAC is a non-scarring simple, OPD based, sensitive technique for evaluating these easily assessable sites, is the first investigation of choice. Quick reporting help to relieve patient anxiety. This study is aimed to tell reliability and utility of FNAC in case of face lesions.  Material and Methods: FNAC was performed in face lesion presenting in one year duration along with clinical and radiological details. The cytology reports were correlated with histopathology and immunohistochemistry in difficult cases.  Result: Toal 15 face lesions including forehead, facial bones, eye, lacrimal gland, nose, cheek, lips and salivary gland were studied. Majority were female with peak age 45 years. Lesions varied from inflammatory cystic lesions, benign and malignant. Lesions included 4 epidermal cyst,1 sialoadenitis,5 pleomorphic adenoma, 2 squamous cell carcinoma,1 solitary fibrous tumor,1giant cell tumor of mandible and 1 case of metastasis of follicular carcinoma thyroid in facial bone and orbit.

Background: Most of the thyroid swellings are benign and benign neoplasms out number thyroid carcinomas by a ratio of nearly 10:1. Fine needle aspiration cytology (FNAC) is recommended as a screening tool to decide whether a patient requires surgical intervention or can be managed conservatively. The main aim of thyroid FNAC is to distinguish benign from malignant lesions. Materials and Methods: This was descriptive, cross-sectional study conducted in Cytology and Histopathology sections of Pathology department at a tertiary health care center in Jalna, Maharashtra, from January 2022 to June 2023. All patients willing for FNAC of thyroid swelling were screened to enrol in the study and a total 210 cases of thyroid lesions FNAC were included. Results: Patients age ranged from 5 to 70 years and maximum number of the patients have age between 30-39 years (29.52%), followed by 20-29 years (23.33%). In the present study out of 210 cases, 188 (89.52%) were females and 22 (10.47%) were males. Most common cytological lesion in females was nodular goitre (109) followed by Hashimoto thyroiditis (29) out of 188 cases. Most common cytological lesion in males was nodular goitre (12) followed by follicular neoplasia (4) in 22 cases. Conclusion: FNAC is safe, cost effective, invaluable rapid tool helps in diagnosis of thyroid lesion with a higher degree of accuracy. Present study showed sensitivity of 62.5%, specificity 100%, PPV 100% and NPV 73.52. The application of Bethesda system leads to more precise diagnosis of thyroid lesions and helps in standardization of thyroid cytology reporting with improved clinical outcome.

Background: Thyroid disorders are among the most common endocrine conditions globally, with thyroid carcinoma representing a major health concern. Fine-Needle Aspiration Cytology (FNAC) is routinely used for initial evaluation of thyroid nodules; however, its diagnostic accuracy compared to histopathology remains under continuous scrutiny. Objective: This study aimed to assess and compare the diagnostic accuracy of FNAC with histopathology in diagnosing thyroid carcinomas at Maharani Laxmi Bai Medical College, Jhansi. Methods: A retrospective observational study was conducted over three years (January 2014 to December 2017) involving 458 patients who underwent both FNAC and subsequent thyroidectomy. Cytological interpretations were based on the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC), while histopathological diagnoses served as the gold standard. Key diagnostic metrics—sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy—were calculated. Results: FNAC demonstrated a sensitivity of 89.8%, specificity of 98.3%, PPV of 94.2%, NPV of 96.9%, and an overall diagnostic accuracy of 95.4%. The highest concordance between FNAC and histopathology was observed in Bethesda Category II cases (benign), with a minimal false-positive rate. Conclusion: FNAC remains a reliable and efficient diagnostic modality for evaluating thyroid nodules, with excellent specificity and good sensitivity. While FNAC effectively differentiates malignant from benign thyroid lesions, histopathology remains indispensable for definitive diagnosis, particularly in indeterminate categories.

Background and Objectives: Breast lesions are a common diagnostic challenge. While B-mode ultrasound is widely used for initial evaluation, ultrasound elastography (UE) has emerged as a complementary technique to differentiate benign from malignant lesions based on tissue stiffness. This study aims to assess the diagnostic utility of strain and shear wave elastography in characterizing focal breast lesions. Materials and Methods: This prospective observational study included 100 female patients with palpable or imaging-detected breast lesions referred for sonographic evaluation. Each underwent B-mode ultrasound followed by elastography. Lesions were categorized using BI-RADS and elastography scoring systems. Histopathology or FNAC was used as the reference standard. Diagnostic parameters including sensitivity, specificity, PPV, NPV, and accuracy were calculated. Results: Of the 100 lesions evaluated, 68 were benign and 32 were malignant on histopathology. Elastography showed significantly higher stiffness values in malignant lesions (mean elasticity score: 4.3 ± 0.5) compared to benign ones (2.1 ± 0.6, p < 0.001). The sensitivity and specificity of elastography were 91% and 85%, respectively, with a diagnostic accuracy of 88%. A cut-off strain ratio of >3.0 yielded the best discriminatory value. Ultrasound elastography changed management decisions in 27% of cases. Conclusions: Ultrasound elastography is a valuable adjunct to conventional B-mode imaging in differentiating benign from malignant breast lesions. It enhances diagnostic confidence and may reduce unnecessary biopsies when interpreted alongside clinical and sonographic findings

Background: Incidental thyroid nodules (ITNs) are frequently identified during imaging studies performed for unrelated indications. Their increasing detection warrants systematic evaluation to determine their clinical significance and malignancy risk. Objectives: To evaluate the prevalence, imaging characteristics, and cytological outcomes of ITNs detected on neck and chest imaging modalities. Methods: This retrospective observational study included 100 patients with incidentally detected thyroid nodules identified on CT, MRI, or ultrasound conducted for non-thyroid-related complaints. Data were collected on demographics, imaging modality, nodule size, location, composition, ultrasonographic features, thyroid function tests (TFTs), and fine-needle aspiration cytology (FNAC) results. Nodules were classified based on standard radiologic descriptors and Bethesda cytology criteria. Results: The mean age of the patients was 52.6 ± 13.4 years, with a female predominance (68%). ITNs were most commonly detected on CT (52%), followed by ultrasound (31%) and MRI (17%). Right-lobe involvement was seen in 42%, left in 36%, and bilateral in 22%. Nodules ranged in size with 45% being 1–2 cm, and 20% exceeding 2 cm. Solid composition was most frequent (54%). Among 65 patients evaluated by ultrasound, 43.1% were hypoechoic; 18.5% had irregular margins and 13.8% showed microcalcifications. FNAC was performed in 28 cases; 71.4% were benign, while 14.2% were either malignant or suspicious for malignancy. Most patients (91%) were euthyroid on TFTs. Conclusion: ITNs are common and require structured evaluation, especially those with suspicious imaging features. Early identification of malignancy aids in timely intervention.

Background: Benign breast diseases (BBD) represent a heterogeneous group of disorders affecting up to 30% of women, often mimicking malignant conditions and causing significant patient anxiety. The ANDI (Aberrations of Normal Development and Involution) classification system offers a standardized approach to categorize and manage these conditions.

Objective: This study aimed to assess the utility of the ANDI classification in diagnosing and guiding treatment for BBD. Methods: A prospective clinical study was conducted on 100 female patients presenting with BBD at a tertiary care center from October 2024 to February 2025. Patients were classified using ANDI criteria, and data were analyzed for clinical presentation, imaging (ultrasonography, mammography), cytology (FNAC), histopathology, and treatment outcomes. Inflammatory conditions and malignancies were excluded.

Results:

• Disease distribution: Fibroadenoma (60%, *n*=60) was the most common diagnosis, followed by cyclical mastalgia with nodularity (30%, *n*=30), incapacitating mastalgia (5%, *n*=5), duct ectasia (3%, *n*=3), and giant fibroadenoma (2%, *n*=2).
• Age correlation: Peak incidence occurred in women aged 21–30 years (56%), with fibroadenoma predominating in this group (42%). Cyclical mastalgia was most frequent in ages 31–40 (16%).
• Clinical features: 50% of fibroadenomas presented as painless lumps; mastalgia cases typically involved bilateral breast pain (35%).
• Management: Surgical excision was performed for fibroadenomas (55/60) and duct ectasia (3/3), while mastalgia cases (30 cyclical, 5 incapacitating) responded to medical therapy (analgesics, hormonal modulation).

Conclusion: The ANDI classification effectively stratifies BBD, enabling tailored management. Fibroadenoma and mastalgia are the most prevalent entities, with age and symptom patterns aiding diagnosis. Conservative therapy suffices for functional disorders, while surgery remains definitive for localized lesions.

Background: Salivary gland lesions present a diagnostic challenge due to their complex histomorphological spectrum and cytological overlap between benign and malignant entities. Fine-needle aspiration cytology (FNAC) is widely used as a minimally invasive, cost-effective, and efficient tool for preoperative evaluation. However, issues such as sampling errors and interpretative pitfalls can impact its diagnostic accuracy. This study aimed to assess the diagnostic performance of FNAC in salivary gland lesions by correlating cytological findings with histopathological outcomes. Materials And Methods A retrospective study was conducted at the Department of Pathology, Government Medical College, Srikakulam, over a two-year period (January 2023 to December 2024). A total of 93 cases with salivary gland swellings underwent FNAC, out of which 44 cases had subsequent histopathological evaluation following surgical excision. Demographic details, anatomical site, FNAC diagnosis, and histopathological findings were analyzed to determine sensitivity, specificity, and concordance rates. Results Among the 93 patients, the majority were male (55.91%) with a mean age of 35.42 years. The parotid gland was most frequently affected (72.04%). FNAC diagnoses included 41.93% non-neoplastic, 43.01% benign neoplasms, and 15.05% malignant lesions. Cytohistological correlation was available in 44 cases, showing a concordance rate of 93.18%, with discrepancies noted in three cases. FNAC demonstrated a sensitivity of 66.7%, specificity of 95.2%, positive predictive value of 80%, and negative predictive value of 90.9%. Conclusion: FNAC is a reliable initial diagnostic modality for salivary gland lesions, particularly when interpreted by experienced cytopathologists. Despite some limitations in cystic and low-grade malignant tumors, its high specificity and strong negative predictive value make it invaluable in clinical decision-making. Image-guided FNAC and continuous diagnostic training are recommended to further enhance its accuracy.

Introduction: Myasthenia Gravis (MG), an archetypal autoimmune neuromuscular junction disorder, is frequently associated with thymic pathologies, particularly thymoma. The intricate immunopathological axis between the thymus and the development of MG necessitates an integrated clinical and surgical approach. This study explores the spectrum of presentations, diagnostic frameworks, and surgical outcomes of patients with MG and/or anterior mediastinal masses in a high-volume cardiothoracic surgical centre in Eastern India. Aims and Objectives: To clinically evaluate patients presenting with thymic mass and/or MG. To determine diagnostic strategies for accurate identification of thymic abnormalities and neuromuscular dysfunction. To assess the role of pharmacotherapy in perioperative stabilization. To evaluate intraoperative management and postoperative recovery in thymectomy. To document post-thymectomy outcomes and relapse patterns during follow-up. Methodology: A prospective observational analysis was conducted from 2021–2024 at IPGME&R and SSKM Hospital, Kolkata. Patients presenting with clinical features of MG and radiologically confirmed thymic masses were included. Diagnostic modalities comprised serological testing (AChR and MuSK antibodies), pulmonary function testing, CT thorax, and FNAC/biopsy. Surgical interventions (thymectomy) were performed where indicated, and outcomes were tracked over a minimum of 6 months postoperatively. Results: The cohort exhibited a male predominance with a peak incidence in the fourth decade. Clinical features such as ptosis, diplopia, dysphagia, and respiratory difficulty were prevalent. CT imaging revealed anterior mediastinal lesions suggestive of thymoma in a substantial number. Surgical resection (thymectomy) was associated with significant reduction in symptom burden and AChR antibody titres. Postoperative extubation was successful within 3 days for most, and over 70% achieved Minimal Manifestation Status (MMS) at follow-up. Conclusion: The study reaffirms the central role of thymectomy in the management of thymic mass and MG, supported by preoperative immunological stabilization. Early surgical intervention coupled with vigilant postoperative care yields durable symptomatic and immunological remission in a significant proportion of patients. A multidisciplinary, evidence-informed paradigm is essential for optimizing outcomes in this complex immunosurgical domain.

Background: Salivary gland lesions constitute a heterogeneous group of neoplastic and non-neoplastic disorders with wide histological diversity. Fine needle aspiration cytology (FNAC) serves as a rapid, cost-effective, and minimally invasive preoperative diagnostic tool. However, histopathological examination (HPE) remains the gold standard for final diagnosis. Objectives: To analyze the spectrum of salivary gland lesions in surgically resected specimens and to evaluate the diagnostic accuracy of FNAC by correlating cytological findings with histopathological outcomes. Materials and Methods: This prospective study was conducted in the Department of Pathology, Maharajah’s Institute of Medical Sciences, Nellimarla, Vizianagaram, from June 2010 to June 2014. A total of 34 surgically resected salivary gland specimens with prior FNAC reports were included. Relevant clinical data were recorded. Specimens were grossly examined, processed, and stained with Hematoxylin and Eosin for histopathological evaluation. Cytohistological correlation was carried out, and diagnostic accuracy parameters were calculated. Results: Of the 34 cases, benign neoplasms (67.65%) outnumbered malignant neoplasms (20.59%) and non-neoplastic lesions (11.76%). Pleomorphic adenoma was the most common benign tumor (55.88%), while adenoid cystic carcinoma and mucoepidermoid carcinoma were the predominant malignant tumors. The parotid gland (70.59%) was the most frequently involved site. FNAC showed a sensitivity of 87.5%, specificity of 100%, and overall diagnostic accuracy of 88.24% when compared with histopathology. Conclusion: Pleomorphic adenoma remains the most common salivary gland lesion, with the parotid gland being the principal site of involvement. FNAC proves to be a reliable first-line diagnostic tool with high specificity, but histopathology continues to be indispensable for definitive diagnosis, grading, and management planning.

Background: Soft tissue tumors of the extremities comprise a heterogeneous group of benign and malignant lesions with variable clinical behavior. Accurate preoperative diagnosis is critical for management. Fine-needle aspiration cytology (FNAC) offers a rapid, cost-effective, and minimally invasive diagnostic option, but its accuracy requires validation against histopathology. Objective: To assess the diagnostic accuracy of FNAC in soft tissue tumors of extremities and correlate cytological findings with histopathological diagnoses. Methods: A prospective study was conducted at Bombay Health Care, Ujjain, from May 2024 to April 2025. A total of 120 patients with clinically suspected soft tissue tumors of extremities underwent FNAC followed by histopathological examination. FNAC results were categorized as benign, malignant, or suspicious. Diagnostic indices including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy were calculated using histopathology as the gold standard. Results: Out of 120 cases, FNAC classified 72 (60%) as benign, 40 (33.3%) as malignant, and 8 (6.7%) as suspicious. Histopathology confirmed 70 benign and 50 malignant tumors. FNAC showed 45 true positives, 5 false negatives, 68 true negatives, and 2 false positives. The calculated sensitivity, specificity, PPV, NPV, and diagnostic accuracy were 90%, 97.1%, 95.7%, 93.1%, and 94.2% respectively. Lipoma was the most common benign tumor (42.8%), while pleomorphic sarcoma was the most frequent malignant tumor (32%). Conclusion: FNAC is a simple, safe, and highly accurate technique for evaluating soft tissue tumors of extremities. It serves as an effective first-line investigation to guide management decisions. However, histopathology remains indispensable for definitive diagnosis, grading, and subtyping.

Introduction: Thyroid nodules are a common endocrine presentation requiring accurate differentiation between benign and malignant lesions. The Thyroid Imaging Reporting and Data System (TIRADS) provides a structured ultrasound-based malignancy risk assessment, whereas serum thyroglobulin (Tg) serves as a biochemical marker reflecting follicular activity. Correlating these modalities with cytology may enhance preoperative diagnostic reliability. Aim: To compare the TIRADS scoring system with serum thyroglobulin levels in the cytological diagnosis of thyroid lesions. Methods: A cross-sectional study was conducted among 50 patients presenting with thyroid nodules at Shri Atal Bihari Vajpayee Medical College and Research Institute, Bengaluru. All patients underwent ultrasound-based TIRADS classification, fine-needle aspiration cytology (FNAC) using the Bethesda system, and serum Tg estimation by chemiluminescent immunoassay (Beckman Coulter Access 2). Data were analyzed using SPSS v21; ANOVA, chi-square, and ROC analyses determined associations and diagnostic performance. Results: Mean age was 42.7 ± 13.4 years, with females comprising 66 %. Distribution across TIRADS categories was TR2 (12 %), TR3 (34 %), TR4 (26 %), and TR5 (28 %). Mean serum Tg rose significantly with higher TIRADS grades (24.7 → 142.6 ng/mL, p < 0.001; η² = 0.55). Cytological diagnosis correlated strongly with both TIRADS (χ² = 16.04, p = 0.001) and Tg (ANOVA F = 13.91, p < 0.001). Mean Tg levels differed markedly between benign (45.3 ± 27.1 ng/mL) and malignant (138.9 ± 70.8 ng/mL) lesions (p < 0.001; AUC = 0.84). Integration of TIRADS, cytology, and Tg improved diagnostic accuracy to AUC = 0.91, surpassing cytology alone (ΔAUC = +0.09; p = 0.028). Conclusion: Serum thyroglobulin levels exhibit a significant positive correlation with increasing TIRADS category and cytological suspicion. The combined use of TIRADS scoring, cytology, and Tg estimation provides superior diagnostic precision for thyroid lesion assessment, offering a reliable, cost-effective triad for preoperative evaluation

Background: Thyroid carcinoma represents the most common endocrine malignancy worldwide, with increasing incidence rates. Despite being relatively rare, accounting for approximately 1-2% of all malignancies, thyroid cancer poses significant diagnostic and therapeutic challenges. Objectives: To evaluate the clinical presentation, pathological distribution, diagnostic accuracy of fine needle aspiration cytology (FNAC), and surgical outcomes of thyroid carcinoma patients at a tertiary care center. Methods: A prospective observational study was conducted from September 2018 to June 2020, including 49 patients with confirmed thyroid carcinoma. Clinical presentation, FNAC results, histopathological findings, surgical procedures, and postoperative complications were analyzed. Statistical analysis included sensitivity, specificity, and predictive values of FNAC compared to histopathology. Results: The mean age was 42.3 years with female predominance (71.4%). Thyroid swelling was the predominant presentation (95.9%). Papillary carcinoma constituted 79.5% of cases, followed by follicular carcinoma (16.3%). FNAC demonstrated 73.5% sensitivity and 98.7% specificity. Total thyroidectomy was performed in 83.7% of patients. According to AMES criteria, 63.8% were classified as low-risk. Transient hypoparathyroidism occurred in 20.4% of cases. Stage I disease was most common (61.2%) per AJCC 2017 classification. Conclusions: Papillary carcinoma remains the predominant thyroid malignancy with excellent prognosis when diagnosed early. FNAC serves as a reliable initial diagnostic tool despite moderate sensitivity. Total thyroidectomy remains the preferred surgical approach with acceptable complication rates.

Background Palpable breast swelling, whether benign or malignant, results from hormonal influences. Most cases are benign. Triple assessment-clinical, histological, and radiological-enables accurate detection and evaluation, guiding effective interventions. The research aimed to compare the patterns of breast swelling in premenopausal and postmenopausal women and identify the most common breast lumps in each group. Methods One hundred female patients with palpable breast lumps were evenly divided into premenopausal (50 patients) and postmenopausal groups (50 patients). Each patient underwent clinical examination, fine-needle aspiration cytology (FNAC), and core needle biopsy if necessary. Ultrasonography (USG) of the breast was conducted for all patients, and mammograms were performed for selected cases. All postoperative specimens underwent histopathological examination. Results Among the total 100 patients, 60 were diagnosed with benign breast disease, and 40 had malignant breast disease. In premenopausal women, 82% were diagnosed with benign disease, while in postmenopausal women, 38% had a benign diagnosis. Conversely, premenopausal women showed an 18% incidence of malignant breast disease, while postmenopausal women exhibited a 62% incidence. Among malignant breast diseases, 60% were invasive ductal carcinoma, 32.5% were invasive lobular carcinoma, 5% were invasive medullary carcinoma, and 2.5% were inflammatory carcinoma. Conclusion The study finds a higher prevalence of malignant breast disease in postmenopausal women, while premenopausal women commonly experience benign breast disease, notably fibrocystic cystic disease. Premenopausal women exhibit a higher percentage of invasive lobular carcinoma than the general population, while postmenopausal women predominantly face invasive ductal carcinoma breast NST/NOS with increased invasive lobular carcinoma.

Introduction:The increasing detection of thyroid nodules through advanced imaging techniques highlights the need for non-invasive diagnostic methods. Sonoelastography, a novel ultrasound technique measuring tissue elasticity, appears promising for assessing thyroid nodules. This study aims to evaluate the diagnostic accuracy of sonoelastography in distinguishing benign from malignant thyroid nodules, focusing on its sensitivity, specificity, and correlation with histopathological findings. Materials and Methods: The study conducted at Department of Radiodiagnosis at Nandha Medical College and Hospital, Erode, Tamil Nadu, involved 40 individuals with identifiable thyroid nodules, who underwent high-frequency B-mode ultrasound and sonoelastography, followed by fine needle aspiration cytology (FNAC) for cytological analysis. Results: In this investigation, a cohort of 40 participants with clinically identifiable thyroid nodules underwent a diagnostic regimen comprising high-frequency B-mode ultrasound followed by sonoelastography. Each case was further evaluated using fine needle aspiration cytology (FNAC) for cytological analysis. The study found that the concurrent application of sonoelastography and B-mode ultrasound accurately classified thyroid nodules as benign or malignant in 87.5% of instances. Specifically, sonoelastography demonstrated a high sensitivity of 94.1%, indicating its efficacy in correctly identifying malignant nodules. Its specificity was recorded at 81%, reflecting its ability to recognize benign nodules. The positive predictive value, an indicator of the likelihood that patients with a positive screening test truly have the disease, was notably high at 98.2%. Conversely, the negative predictive value, which assesses the probability that patients with a negative screening test are disease-free, was 87%. Conclusion:The findings confirm the value of sonoelastography as a reliable and non-invasive method for evaluating thyroid nodules. Its high sensitivity and specificity demonstrate its potential to enhance diagnostic accuracy as an adjunct to B-mode ultrasound, potentially decreasing the need for invasive FNAC and thus reducing patient discomfort and healthcare costs. The successful use of sonoelastography in this study supports its integration with traditional ultrasound techniques to improve diagnostic outcomes. Future research with larger and more varied populations is essential to further validate these results and advance the adoption of sonoelastography in routine clinical practice, potentially transforming the management of thyroid nodule cases.

Background: Epididymal swellings are frequently encountered in urological practice. Fine-needle aspiration cytology (FNAC) provides a rapid, inexpensive, and minimally invasive diagnosis, while ultrasonography (USG) serves as a valuable non-invasive imaging modality. Correlating both can significantly improve diagnostic precision and management. Objective: To assess the cytological spectrum of epididymal lesions, correlate FNAC findings with ultrasonographic features, and evaluate diagnostic accuracy against histopathology. Methods: This prospective observational study included 60 patients presenting with epididymal swellings. All patients underwent high-frequency scrotal ultrasonography, followed by FNAC. Smears were stained with May-Grünwald-Giemsa (MGG) and Papanicolaou stains; Ziehl–Neelsen stain was applied for suspected granulomatous lesions. Histopathological correlation was available in 25 surgically managed cases. Results: Of 60 cases, 52 (86.7%) were benign and 8 (13.3%) were neoplastic. Tuberculous epididymitis was the most common lesion (18 cases, 30%), followed by non-specific inflammation (15, 25%), sperm granuloma (10, 16.7%), and benign cystic lesions (9, 15%). Neoplastic lesions included adenomatoid tumor (5 cases) and papillary cystadenoma (3 cases). USG showed concordant diagnosis with FNAC in 51 (85%) cases. Histopathological confirmation showed FNAC accuracy of 92%, USG accuracy of 84%, and combined FNAC+USG accuracy of 96%. Conclusion: FNAC is a reliable diagnostic tool for epididymal lesions, capable of distinguishing inflammatory from neoplastic conditions. When correlated with USG findings, diagnostic accuracy and patient management outcomes improve substantially.

Background: Thyroid nodules are common endocrine disorders, with most being benign, although a small proportion may be malignant. Accurate evaluation is essential for appropriate diagnosis and management. Fine needle aspiration cytology (FNAC), ultrasonography (USG) with TIRADS classification, and thyroid function tests (TFTs) play a key role in assessment. Aim: To analyze the cytomorphological spectrum of palpable thyroid lesions and correlate findings with sonographic and biochemical parameters. Methods: This prospective observational study included 96 patients with palpable thyroid lesions conducted over two years at K.M. Medical College and Hospital. FNAC was performed and reported using the Bethesda System for Reporting Thyroid Cytopathology. Ultrasonographic evaluation was done using TIRADS classification, and TFTs (T3, T4, TSH) were assessed using chemiluminescence immunoassay. Data were analyzed using SPSS software. Results: Most patients were in the 20–50 years age group (68.8%) and euthyroid (54.2%). Colloid goitre was the most common clinical (67.7%) and radiological (41.7%) diagnosis. Cytologically, benign lesions predominated (45.8%), with colloid goitre being the most frequent finding. Most nodules were classified as TIRADS 1 (69.8%), indicating low malignancy risk. FNAC showed adenomatous nodules as the most common diagnosis (50%), while malignant cases were rare (2.1%). Higher Bethesda categories correlated with suspicious ultrasound features such as hypoechogenicity and microcalcifications. Conclusion: FNAC combined with ultrasonography and biochemical assessment provides a reliable and effective diagnostic approach. An integrated evaluation improves diagnostic accuracy, facilitates early detection of malignancy, and supports appropriate management of thyroid lesions.