Application of the Milan System for Risk Stratification and Its Comparison with a Previous Reporting System of Parotid Gland Cytopathology in a Tertiary Care Centre

2018 ◽  
Vol 62 (5-6) ◽  
pp. 352-359 ◽  
Author(s):  
Archana George Vallonthaiel ◽  
Seema Kaushal ◽  
Hemlata Jangir ◽  
Hemanth Kumar Rajendran
Keyword(s):  
Risk Stratification ◽  
Parotid Gland ◽  
Reporting System ◽  
Tertiary Care ◽  
Malignant Neoplasm ◽  
Tertiary Care Centre ◽  
Fine Needle Aspirates ◽  
Parotid Region ◽  
Malignant Group ◽  
Risk Of Malignancy

Objective: To compare the recently proposed Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) with the four-tiered reporting system (FTRS) followed at our institute. Methods: Parotid gland fine-needle aspirates reported over a period of 5 years were analysed. These aspirates had been placed into 4 categories according to the FTRS: unsatisfactory (UNS), no evidence of malignancy/negative (NEG), inconclusive for malignancy (INC), and diagnostic for malignancy/positive (POS). Aspirates with follow-up histopathology were then categorized according to the MSRSGC as follows: non-diagnostic, non-neoplastic, atypia of unde­termined significance (AUS), neoplasm, suspicious for malignancy, and malignant. The risk of malignancy (ROM) was calculated. Results: A total of 893 parotid region aspirates were evaluated and histopathology was available for 190 cases (21%). ROM in MSRSGC groups, namely non-diagnostic, non-neoplastic, AUS, neoplasm, suspicious for malignant neoplasm, and malignant, was 44, 8, 0, 12, 81 and 100%, respectively. ROM in FTRS groups, namely UNS, NEG, INC, and POS, was 45, 13, 67 and 100%, respectively. Conclusions: MSRGC and FTRS are comparable with respect to the ROM across groups. Compared to FTRS, the further subcategorisation of the non-malignant group, the use of specific nomenclature, and the reproducibility of MSRGC provide proper risk stratification, thereby guiding better management and resulting in improved patient care.

A prospective observational study on the effectiveness of risk of malignancy index score (RMI 3) in a tertiary care centre in Eastern India

2020 ◽  
Vol 11 (5) ◽  
pp. 54-60
Author(s):  
Apurba Mandal ◽  
Shibram Chattopadhyay ◽  
Sushanta Mondal ◽  
Arunava Biswas
Keyword(s):  
Ovarian Cancer ◽  
Adnexal Mass ◽  
Malignant Tumors ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Ca 125 ◽  
Tertiary Care Centre ◽  
Gynecology And Obstetrics ◽  
Risk Of Malignancy ◽  
Malignant Lesions

Background: Adnexal mass is a common presentation in today’s gynecological practice. The incidence of ovarian cancer is increasing day by day and diagnosis is often difficult to be made pre operatively with inadequate surgical exploration is a regular occurrence. Aims and Objectives: To assess and validate the importance of RMI-3 score as pre-operative diagnostic tool of differentiating benign from malignant adnexal mass for starting first line therapy of ovarian cancer and to find out the incidences of ovarian malignancy among study population. Material and Methods: The study was conducted in the Department of Gynecology and Obstetrics on (n=115) patients attending GOPD and indoor with adnexal mass fulfilling the inclusion and exclusion criteria using purposive sampling technique. All the selected cases underwent ultrasonography and serum CA- 125 level estimation necessary for calculating RMI score. A score of >200 was taken as suggestive of malignancy and confirmatory diagnosis was performed by histopathological examination obtained from staging laparotomy of adnexal mass. The individual scores were then correlated with final outcomes with statistical analyses. Results: The study revealed benign ovarian tumors are more under 50 years (78.46%) and patients with normal BMI are diagnosed with maximum of malignancy (n = 28). History of tubal ligation carried less risk of malignancy (p<0.0001). Histologically malignant tumors found mostly in 71.4% postmenopausal group whereas 94.1% benign pathology were present in perimenopausal group and there is no association found between parity and histopathology (p=0.058). Bilateral (p=0.013), multilocular (p=0.000) tumors with solid areas (p<0.0001) and thick papillary projections (p<0.0001) had statistically significant association with malignant lesions. RMI score (>200) had more efficacy than serum CA-125 level (>46) in differentiating malignant lesions from benign one in terms of specificity (96% vs 83.87%) and positive predictive value (95% vs 79.17%). Conclusions: RMI-3 score is a simple, reliable and effective tool in differentiating benign from malignant adnexal masses thereby help in quick referral and management of cases with increase chances of survival of the patients.

An Insight into the Utility of Sub-Categorisation of Atypia of Undetermined Significance for Risk Stratification: A Retrospective Study on an Indian Cohort with Histopathological Correlation

2019 ◽  
Vol 63 (3) ◽  
pp. 182-188 ◽  
Author(s):  
Sanjeet Roy ◽  
Anne Jennifer Prabhu ◽  
Deepak Thomas Abraham ◽  
Paul Mazhuvanchary Jacob ◽  
Marie Therese Manipadam
Keyword(s):  
Risk Stratification ◽  
Observer Variation ◽  
Cytological Atypia ◽  
Fine Needle Aspirates ◽  
Histopathological Correlation ◽  
Not Otherwise Specified ◽  
Risk Of Malignancy ◽  
Effective Role ◽  
Insight Into ◽  
Undetermined Significance

Background: Atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS) criterion in thyroid fine-needle aspirates (FNAs) has been a heterogeneous entity with much inter-observer variation. Sub-categorisation of AUS/FLUS has been observed to play an effective role in risk stratification. We aimed to validate AUS/FLUS sub-categorisation in correlation with the spectrum of malignancy. Study Design: Subjects included patients with AUS/FLUS diagnosed between January 2015 and December 2016. AUS/FLUS cases were sub-categorised into those exhibiting (1) architectural atypia, (2) cytological atypia, (3) architectural and cytological atypia, (4) AUS with Hürthle cells, and (5) AUS not otherwise specified (AUS-NOS). Each sub-category was correlated with their corresponding incidence of malignancy in surgical resections. Result: The overall incidence of AUS/FLUS in our centre was 13% (132/1,018). On retrospective review of 117 patients with AUS/FLUS, smears with cytological atypia showed a higher incidence of malignancy (78.3%) than those with architectural atypia (75.3%). AUS/FLUS cases with both cytological and architectural atypia had a malignancy rate of 71.4%. Conclusion: AUS/FLUS cases with cytological atypia had a higher risk of malignancy than those with architectural atypia. The sub-categorisation of AUS/FLUS is diagnostically important for the proper risk stratification of patients.

Subcategorisation of AUS/FLUS thyroid lesions as per the 2017 Bethesda System for Reporting Thyroid Cytopathology: a retrospective study from a tertiary care centre analysing risk of malignancy (ROM) of the different subcategories

2019 ◽  
Vol 72 (11) ◽  
pp. 771-777 ◽  
Author(s):  
Prerna Guleria ◽  
Shipra Agarwal ◽  
Venkateswaran K Iyer ◽  
Deepali Jain ◽  
Sandeep R Mathur ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Lymphoid Cells ◽  
Follicular Neoplasm ◽  
Tertiary Care Centre ◽  
Relative Decrease ◽  
Risk Of Malignancy ◽  
Bethesda System ◽  
C 50 ◽  
Thyroid Cytopathology ◽  
Undetermined Significance

AimsThe 2017 Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) recommends subclassification of atypia of undetermined significance (AUS)/follicular lesion of undetermined significance (FLUS) into six subcategories. The present study evaluates the risk of malignancy (ROM) and risk of neoplasm (RON) among these.MethodsAll thyroid aspirates reported as AUS/FLUS over a 4.5-year period, with available histology, were reviewed and subclassified as per TBSRTC. ROM and RON were calculated and compared.ResultsOf 2554 thyroid aspirates, 281 (11.0%) were AUS/FLUS. Eighty-one with available histology were evaluated. ROM was 51.8%. Cytologic and architectural atypia (AUS-C&A) was the most prevalent (62.9%), followed by Hürthle cell type (19.6%), AUS-A (11.1%), AUS-not otherwise specified (NOS) (7.4%), cytologic atypia (AUS-C) (4.9%) and atypical lymphoid cells (1.2%). Papillary thyroid carcinoma (PTC) and adenomatous goitre (AG) were the most common histological diagnoses (27% each). On histology, AUS-C had 2/4 PTC and 2/4 AG on histology. AUS-A had 4/9 follicular neoplasm (FN) and 2/9 non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) while AUS C&A had 18/51 PTC, 13/51 AG, 11/51 NIFTP and 5/51 FN. ROM and RON were similar across subcategories, ROM was the highest for AUS-C&A (58.8%), AUS-C (50%) and AUS-NOS (50%). NIFTP reclassification as non-malignant reduced ROM to 35.8% (absolute reduction of 16% and a relative decrease of 31%) with the greatest relative decrease seen in AUS-A (50%), followed by AUS-C&A (37%), and none in others.ConclusionsAUS/FLUS subcategorisation helped to indicate risk for the more likely neoplasm, whether PTC or FN. ROM was the highest for cases with cytological atypia but did not differ significantly across different subcategories. NIFTP changed the ROM of AUS-A and AUS-C&A, since both NIFTP and FN have microfollicles.

scholarly journals Salivary gland tumours: a retrospective study at a tertiary care centre in South India

2021 ◽  
Vol 7 (5) ◽  
pp. 825
Author(s):  
Neha Swarnkar ◽  
Srinivasan Venkataraman ◽  
Prasanna Kumar Saravanam
Keyword(s):  
Salivary Gland ◽  
Retrospective Study ◽  
Parotid Gland ◽  
Pleomorphic Adenoma ◽  
South India ◽  
Tertiary Care ◽  
Salivary Gland Tumors ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Salivary Gland Tumours

<p><strong>Background:</strong> Salivary gland tumors are morphologically and histologically diverse group of lesions and their frequency varies in several parts of the world. Better understanding of these tumours will help in assessing the behaviour and outcomes of lesions of this region. The aim of this study was to analyse the charactertistics of different tumours occurring in the salivary gland in a tertiary care centre in South India.</p><p class="abstract"><strong>Methods:</strong> A retrospective study was conducted of salivary gland tumors diagnosed from the year 2015 to 2020. Patient age and gender, tumor site and frequency, histopathological diagnosis were evaluated and analysed.</p><p class="abstract"><strong>Results:</strong> A total of 36 salivary gland tumor cases was identified, 30 (87.3%) of which were classified as benign and 6 (12.7%) as malignant. Most tumors occurred in the parotid gland (81.3%). Pleomorphic adenoma was the most common tumor in 23 patients (63.8%), followed by warthins tumour. The tumors occurred more often in women than men.</p><p><strong>Conclusion: </strong>The results of the present study reinforce prevalence of salivary gland tumours. The parotid gland is the most common location and pleomorphic adenoma are the most frequent lesions. The malignant tumors also can occur in these glands and good clinical suspicion is necessary.</p><p class="abstract"> </p>

scholarly journals How safe are our children in our own homes? accidental ingestion in children: a 6 year retrospective study from a tertiary care centre

2019 ◽  
Vol 6 (2) ◽  
pp. 449
Author(s):  
Sujay Kumar Earan ◽  
Revathi Krishnakumar ◽  
Sivaraman Sangili ◽  
Arulkumaran Arunagirinathan ◽  
Duvvur Preethika Reddy ◽  
...  
Keyword(s):  
Reporting System ◽  
Tertiary Care ◽  
Food Poisoning ◽  
World Health ◽  
Health Statistics ◽  
Idiosyncratic Drug Reactions ◽  
Accidental Ingestion ◽  
Tertiary Care Centre ◽  
Care Givers ◽  
Cleaning Agents

Background: According to the World Health statistics, in 2016 more than 100000 deaths were caused due to unintentional poisonings. Children are vulnerable due to their smaller body surface area, an inherent behaviour of negation, curiosity in exploring their surroundings, their initial phallic stage where they tend to put any objects they come across into their mouth.Methods: This study is a hospital based retrospective observational study where the records of all the children admitted due to poisoning, accidental or intentional from June 2012 to November 2018 were reviewed. All the children admitted due to food poisoning and idiosyncratic drug reactions were excluded from the study.Results: A total of 203 cases of accidental ingestion were admitted during the study period, of which the majority of the patients were male children. The age group varied from 5 months to 14 years. Majority of the accidental ingestions were due to kerosene (108), followed by insecticides (25) and cleaning agents (20).Conclusions: Poisoning in young children is unintentional and accidental; hence the introduction of safe child resistant containers should be encouraged in storing harmful chemicals. Knowledge about the chemicals, awareness about their hazardous effects and education of the care givers about safe storage would be the first step in the prevention of accidental ingestion. Establishment of a reporting system from all the health care centres and establishment of poison information system at all the levels is the need of the hour.

scholarly journals Risk stratification in acute coronary syndrome: Evaluation of the GRACE and CRUSADE scores in the setting of a tertiary care centre

2019 ◽  
Vol 74 (2) ◽  
Author(s):  
Katharina Tscherny ◽  
Calvin Kienbacher ◽  
Verena Fuhrmann ◽  
Raphael Tulder ◽  
Wolfgang Schreiber ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Risk Stratification ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Coronary Syndrome

scholarly journals Spectrum of primary epithelial tumors of major salivary glands: a 5 year record based descriptive study from a tertiary care centre

2017 ◽  
Vol 4 (2) ◽  
pp. 562
Author(s):  
Jayalakshmy Payippat Leelamma ◽  
Bhavya P. Mohan
Keyword(s):  
Salivary Gland ◽  
Parotid Gland ◽  
Salivary Glands ◽  
Pleomorphic Adenoma ◽  
Mucoepidermoid Carcinoma ◽  
Malignant Tumors ◽  
Tertiary Care ◽  
Benign Tumors ◽  
Care Centre ◽  
Tertiary Care Centre

Background: Salivary gland tumors constitute a highly heterogeneous histopathologic group. There are few epidemiological studies of large series of benign and malignant epithelial tumors of major salivary glands in South India.Methods: This is a retrospective study in a tertiary care centre in Kerala, South India. A total of 180 epithelial neoplasms of major salivary gland were studied over a 5 year period. In each case age, sex, anatomical location and histopathological diagnosis were recorded.Results: Patients with benign and malignant tumors presented with a mean age of 52.3 and 55.9 years respectively. The frequency of benign tumors was 80.6% (n = 145) and of malignant tumors was 19.4% (n = 35). There was a higher prevalence of tumors in males 60.6% (n = 109) than in females 39.4% (n = 71). 91.9% (n = 164) of the tumors were localized in the parotid gland, 8.3% (n = 15) in the submandibular gland and 0.6% (n = 1) in the sublingual gland. The most common benign tumors were Pleomorphic adenoma (48.9%, n = 88) and Warthin’s tumor (28.9%, n = 52). Among malignant tumors, Mucoepidermoid carcinoma was the most common (9.5%, n = 17) followed by Carcinoma ex pleomorphic adenoma (2.8%, n = 5) and adenoid cystic carcinoma (2.2%, n = 4).Conclusions: Parotid gland was the most common site of both benign and malignant tumours. Plemorphic adenoma was the most common benign tumor and mucoepidermoid carcinoma was the most common malignant tumor.

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