Background:Fine needle aspiration cytology (FNAC) has a high rating in the assessment of breast lesions. Various methods have been used to diagnose cytology of breast lesions.Aims:Present study was undertaken to evaluate the feasibility of application of systematic pattern analysis based on morphology in diagnosing breast aspirates.Materials and Methods:This is a retrospective study of FNAC of the breast done over a period of 4 years in a tertiary care centre. A total of 225 cases of breast lesions for which FNAC was done with histological follow-up were included in the study. Breast aspirates were provisionally diagnosed based on systematic pattern analysis. Aspirates were grouped into six categories based on predominant cellular pattern, and correlation between cytological and histological diagnosis was assessed.Results:Application of pattern analysis on FNAC of breast lesions in our study had a sensitivity of 94.5%, specificity of 98%, diagnostic accuracy of 97%, positive predictive value of 95.8%, and negative predictive value of 97.4%.Conclusions:Systematic pattern analysis based on morphology of FNAC smears was found to be highly reliable and could be easily reproducible in the assessment of breast masses.
Assigning a tumor grade to breast cancer provides important prognostic information and guides optimal therapy. The present study was undertaken to grade breast carcinoma on aspirates by Robinson grading (RGS) and Scarff-Bloom-Richardson grading system (SBR). Histological grading was done according to Nottingham modification of Scarff-Bloom-Richardson method and the two cytological grading systems were compared. Fifty cases of breast carcinoma with preoperative cytologic diagnosis were assigned tumor grade. Histologic grading was done on corresponding mastectomy or partially resected specimens. Statistical analysis was performed; correlation between cytologic and histologic grading was established using Spearman correlation coefficient. Regression analysis was done to assess the significance of each cytological feature. Univariate analysis showed strong correlation (P < 0.01) for all features except dissociation. Multiple regression analysis of cytologic features revealed cell dissociation nucleoli and nuclear margin as the most influential features. A concordance of 72.5% between RGS (cyto) and SBR (cyto), 64% for RGS (cyto) and SBR (histo), 82% for SBR (cyto) and SBR (histo) was noted. There was a significant association (P < 0.001) between the grades assigned to cytologic and histologic specimens. Cytologic grade could be used to predict histologic grade as significant relationship exists between grades assigned to cytologic and histologic specimens.
Calcinosis cutis is a condition of accumulation of calcium salts within the dermis. We are presenting four cases of calcinosis cutis, with different clinical presentations, occurring in healthy individuals, with normal serum calcium and phosphorus levels. Histologically, all cases showed similar morphology, the lesions were composed of large and small deposits of calcium. Foreign-body giant cell reaction was seen in one case. Another case had intact and ruptured epidermal cysts and calcification within the cyst.
Aim:To audit the fresh frozen plasma (FFP) usage with an insight into various guidelines.Materials and Methods:The blood bank records pertaining to FFP usage in patients admitted in our medical college hospital were retrospectively reviewed for 2 years for usage of FFP in various departments and evaluated for appropriateness of usage based on various guidelines, which included the 2013 guidelines published by the National Health and Medical Research Council and the Australasian Society for Blood Transfusion.Results:A total of 785 units of FFPs were transfused to 207 patients during the study period. The appropriate usage was found to be 59.3%, and the usage was most appropriate in massive transfusions.Conclusion:This study highlights the nonadherence to guidelines among clinicians which is mainly due to lack of knowledge of appropriate usage.
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