The utility of fine needle aspiration biopsy (FNAB) guided by real-time ultrasooograpby was studied in 25 patients referred with peripheral lung opacities on chest x-ray examination and in whom fiberoptic bronchoscopy was negative. The lesion, as seen on a chest x-ray, was visualized sonographically in 22 (88%) patients, and aspiration biopsy was performed in 20 of these 22 patients, two patient. s being excluded due to sonographic evidence of a hydatid cyst. Aspiration biopsy was diagnostic in 17 (85%) of the 20 patients studied including 12 patients with malignancy and five patients with benign lesion. One patient developed a small asymptomatic pneumothorax, detected on routine postprocedure chest x-ray examination. Thus fine needle aspiration biopsy under ultrasonographic guidance is a safe, economical method with a high diagnostic yield in the evaluation of peripheral lung opacities, especially in developing countries where computed tomography scan facilities are limited and costly.

A 25yrs old lactating women present with membranous lesion of the tongue, painful ulceration of mouth and vulva. The differential diagnosis of vulval ulcer includes various causes of acute vulval lesion usually associated with STD, malignancy and immunosuppressive disease. Later it is diagnosed as a case of vulval tuberculosis. This common lesion is often misdiagnosed, leading unnecessary investigations and treatment.   DOI: 10.3329/bmj.v38i2.3577 Bangladesh Medical Journal 38(2) 2009 65-67