Introduction: The Extrapulmonary Tuberculosis (EPTB) is challenging due to the pauci-bacillary nature of the disease and limited tests available for early diagnosis. It is the most common extrapulmonary manifestation of tuberculosis. The samples from extrapulmonary infection will have low bacterial count as compared with sputum specimens. It is also necessary to rule out other causes of granulomatous inflammation on Fine Needle Aspiration Cytology (FNAC) and confirmation by Ziehl Neelsen (ZN) stain and Cartridge Based Nucleic Acid Amplification Test (CBNAAT). In December 2010, World Health Organisation (WHO) recommended GeneXpert/CBNAAT to be used as the initial diagnostic test in suspected EPTB cases. Aim: To compare FNAC and ZN stain with CBNAAT in the diagnosis of suspected tubercular lymphadenopathy in a tertiary care centre and to know the importance of CBNAAT in the modern era. Materials and Methods: This was a hospital based prospective study carried out over a period of 12 months (July 2019 to June 2020) in the Department of Pathology and Microbiology, ESIC Medical College. All presumptive cases of tubercular lymphadenopathy and purulent aspirates from the lymph nodes of various sites were included in the study. Smears were made after FNA and stained with Haematoxylin and Eosin (H&E) stain and ZN stain and sample was also processed for CBNAAT in all cases of lymphadenopathy. Statistics were done using SPSS software version 20.00. Results: The total number of cases with presumptive tubercular lymphadenitis was 119. Majority of the aspirates are from jugular lymph nodal and cervical swellings 77 (64.7%) out of 119. FNAC has detected tuberculosis in 20 (16.8%) cases and ZN stain detected Acid Fast Bacilli (AFB) in 6 (5%) cases. CBNAAT has detected 28 (23.5%) cases, among them 15 (12.6%) cases which were not detected by FNAC. Diagnostic Performance of CBNAAT versus FNAC 28 out of 119 showed sensitivity, specificity, negative predictive value and positive predictive value 80%, 85.8%, 65% and 45.5%. Conclusion: The CBNAAT can be added with FNAC to get more specific results. CBNAAT is less sensitive for blood stained samples than purulent samples and hence FNAC still remains as the cheapest and first line test to diagnose in cases suspected of tubercular lymphadenoapathy.

Introduction: Testis is affected by both neoplastic and non-neoplastic conditions which can present in all the age groups. Tumor-like proliferations from paratestis often mimic malignancy which results in unnecessary radical orchidectomy. Hence, one has to depend on histopathologic examination for definitive diagnosis. The testicular tumors although relatively rare, are of great interest and importance because of their varied histological appearances. They account for less than 1% of all malignancies in male. Non-neoplastic lesions or tumor-like proliferations from paratestis often mimic malignancy arising from the scrotal sac which results in unnecessary radical orchidectomy. Hydrocele is often associated with trauma and inguinal hernia, rarely it can be secondary to testicular cancer. Whereas pyocele is most often associated with epididymo-orchitis and less often from contiguous spread of bacterial peritonitis. Hence detailed history and pathological examination are required to know the underlying cause. Objective: To know the morphological spectrum of testicular and paratesticular lesions, their incidence in different age groups, laterality, incidence of benign versus malignant lesions and to study their gross, microscopic features. Methodology: This is a 2 years retrospective study from June 2017 to May 2019 at department of pathology, ESIC Medical college, Kalaburagi. Gross specimens, slides and blocks were retrieved and reviewed. Results: Total 49 cases were studied of which 26 were testicular lesions and 23 paratesticular lesions. Non neoplastic testicular lesions were more common than neoplastic lesions (96.1% Vs 3.8%) with majority in the fifth and sixth decade. Right testis was more commonly involved (59.09%) than left testis (31.8%) and bilateral involvement was seen in 9% cases. Atrophic testis was most common testicular lesion whereas Pyocele was most common paratesticular pathology. Conclusion: Testis and paratestis can develop both non neoplastic and neoplastic lesions. Gross morphology can give important clues for pathological diagnosis. However there is a crucial role of microscopic examination for definitive diagnosis of these lesions.

Background: Cervical cancer in women is the second most common cancer and the commonest cause of mortality in developing countries. The introduction of Pap smear test changed the scenario of cervical cancer with an intense drop in the incidence and mortality due to invasive cervical cancer. Aims and Objective: To evaluate the patterns of cervical smear cytology and to correlate the cervical smear diagnosis with histopathological diagnosis and to assess the efficacy of Pap smears in diagnosing cervical lesions. Materials and Methods: This two-year retrospective study (January 2018 to December 2019) was done in the department of Pathology in a tertiary care hospital. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated considering histopathological diagnosis of cervical biopsy as the gold standard. Results: A total of 316 Pap smears were studied, out of which we selected 154 cases who also undergone biopsy or hysterectomy. Epithelial cell abnormalities (ECA) were found in 28 cases (18.2%). Among this the most common ECA was Atypical squamous cells of undetermined significance (ASCUS) seen in 10 cases (6.5%) followed by LSIL (5.2%), HSIL (3.2%) and SCC of cervix (3.2%). The overall correlation between cervical cytology and histopathology was found in 125 out of 154 cases (81.16%). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of pap smear was 90.57%, 62.50%, 95.41%, 43.47% and 87.66% respectively. Conclusion: Pap smear is a simple, safe, non-invasive and effective method for detection of lesions of the cervix and ECA. Hence, better awareness and periodical cytological screening programs can help in the early detection of malignant cervical lesions and thereby reducing the morbidity and mortality related to this malignancy.