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Acute pancreatitis is a significant cause of morbidity and mortality and is known to run an unpredictable course. Severe pancreatitis occurs in 20%-30% of all patients with acute pancreatitis and is characterized by a protracted clinical course, multiorgan failure, and pancreatic necrosis. Modified Computed Tomography Severity Index (MCTSI) is used as a scoring system in acute pancreatitis. This study aims to correlate the MCTSI grading system with patient outcome in terms of organ failure, mortality and duration of hospital stay. Materials and methods: This was a prospective study conducted for a period of two years. 39 Cases diagnosed as acute pancreatitis were included in this study. These patients underwent contrast enhanced computed tomography (CECT) of the abdomen and pelvis. The findings were recorded as per the modified CT severity index. Results: There was significant correlation between necessity of ICU admission and duration of ICU stay and grade of pancreatitis, positive correlation with duration of ward stay and strong correlation with total duration of hospital stay. Higher CT grade is positively associated with development of local complications and systemic complications. Conclusion: Grading by modified CT severity index has a significant correlation with necessity of ICU admission, duration of ICU stay and total duration of hospital stay. Modified CT severity index can be used to predict the possibility of developing local and systemic complications, the need for interventions and necessity of ICU admission.

Immunohistochemistry plays a vital role in the diagnosis of small round cell tumors. CD99 immunonegativity is one of the features, which helps in distinguishing neuroblastoma from other small round cell tumors. NKX2.2 is a specific marker of Ewing sarcoma, which is a differential for poorly differentiated neuroblastoma. Here, we present a case of metastatic neuroblastoma showing immunoreactivity for both CD99 and NKX2.2 on cytology of the metastatic site causing diagnostic dilemma. Biopsy study of the adrenal lesion revealed presence of differentiating cells and neuropil, highlighting the importance of evaluation of the primary site and limitation of cytology.

Background. Image-guided fine needle aspiration cytology (FNAC) has been used to evaluate mediastinal lesions.Methods. Case records of 28 patients with thymic lesions who had undergone computed tomography (CT) -or ultrasonographyguided FNAC of thymic lesions over a period of four years (January, 2012 -December, 2015, retrieved from the cytology register, were retrospectively studied. Malignant lymphomas were excluded. Four smears were prepared for each case; two were stained with Papanicoulaou (Pap) stain and two were stained with May-Grunwald Giemsa (MGG) stain. A cell block was prepared in cases where adequate material was available using formalin fixation and agar method. Immunohistochemistry on cell block was done wherever required and feasible. Final diagnosis was made on the basis of the cytological and histopathological findings (in those cases that underwent biopsy/surgery), and considering the clinical and radiological findings.results. Thymoma accounted for the majority of the cases (n=19; 67.8%), thymic carcinoma (n=6; 21.4%), thymic hyperplasia (n=1; 0.04%), thymolipoma (n=1; 0.04%) and thymic neoplasia (n=1; 0.04%).conclusions. Image-guided FNAC with ancillary tests can be a powerful diagnostic tool in the diagnosis of thymic neoplasms. Although a diagnosis by FNAC has often proved challenging in this area, image guided FNAC along with ancillary techniques can provide an accurate diagnosis, especially in thymic neoplasms. [indian j chest dis allied sci 2019;61; [19][20][21][22][23]

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