Background: This study was designed to determine the accuracy of bronchoalveolar lavage fluid cytology (BAL) using histopathologic examination of transbronchial biopsy specimens as the gold standard in diagnosis of lung carcinoma at our center. Materials and Methods: A retrospective study was conducted to investigate a total of 388 patients who were suspected of having lung cancer and had undergone fiberoptic bronchoscopy in Shahid Sadoughi hospital from 2006 to 2011. Lung masses were proven to be malignant by histology. Results: Transbronchial lung biopsy (TBLB) identified malignancy in 183 of the 388 cases, including 48 cases (26.2%) with adenocarcinoma, 4(2.1%) with bronchioloalveolar carcinoma, 47(25.6%)with squamous cell carcinoma, 34(18.5%) with well-diffentiated neuroendocrine carcinoma, 35(19.1%) with small cell carcinoma, 14 (7.6%) with non-small cell carcinoma, and 1 (0.54%) with large cell carcinoma. A total of 205 cases were correctly classified as negative. BAL was also performed in 388 patients; 86/103 cases were consistent with the final diagnosis of lung cancer and 188/285 cases were correctly classified as negative. The sensitivity of BAL was 46.9%(CI:41.9%, 51.8%)) and its specificity was 91.6%(CI:88.8%, 94.3%). BAL had a positive predictive value (PPV) of 83.4%(CI:79.7%, 87.1%) and a negative predictive value (NPV) of 65.8%(CI:61%, 70.5%). The overall accuracy of BAL was 70.5% and the exact concordance was 39%. Conclusions: Our findings suggest that BAL cytology is not sensitive but is a specific test for diagnosis of lung carcinoma. If transbronchial lung biopsy is combined with bronchoalveolar lavage, the positive diagnostic rate will be further elevated.

SUMMARYHere we report a case of idiopathic granulomatous mastitis (IGM) associated with erythema nodosum (EN) and ankle arthritis. The skin, joint and mammary symptoms improved with corticosteroid. Coincidence of granulomatous mastitis, EN and arthritis is a rare feature. BACKGROUND

Isolated central nervous system (CNS) tuberculoma is a rare disease. This disease is associated with high morbidity and mortality, despite modern methods of detection and treatment. CNS tuberculosis can present as meningitis, arachnoiditis, tuberculomas or the uncommon form of tuberculous subdural empyema and brain abscess. We present the clinical, radiological and pathological findings of cerebellar tuberculoma in an Iranian immunocompetent patient mimicking a malignant tumour.

The authors present a case of intracranial hydatid cyst presented with severe headache, nausea and vomiting. Radiological investigations, including CT scan and MRI revealed a solitary cyst in the right temporal lobe, paraventricular area. Total excision of the cyst was done. The features of this rare disease are retrospectively analysed in this presentation and the literature is reviewed.

SummaryPrimary malignant lymphoma of the female genital tract is an extremely rare clinical entity. We report a case of primary non-Hodgkin lymphoma of the uterine cervix. An 85-year-old woman presented with abnormal genital bleeding. A colposcopic examination revealed a mass in the uterine cervix. No other lesions were detected by the whole-body CT, gallium scintigraphy and bone marrow examination. The histological examination and immunohistochemical staining of the cervical biopsy material confirmed a diagnosis of diffuse large B cell lymphoma of the uterine cervix, clinical stage 1E (according to the Ann Arbor Staging Classification for Lymphomas). The patient was treated with rituximab, cyclophosphamide, hydroxydaunorubicin, vincristine (oncovin) and prednisone. Her family refused surgery and involved field irradiation. She was in good condition but after 5 months she expired due to myocardial infarction. BACKGROUND