Online ISSN: 2515-8260

Keywords : Benign


EVALUATION OF THYROID LESIONS WITH USG AND PATHOLOGICAL CORRELATION

Dr K Lalitha Sree MD Dr Jyoti Brahmaiah MD Dr K Dileep DNB

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 2542-2549

To calculate the incidence of different types of thyroid lesions in rural people.In the diagnosis and characterisation of various thyroid lesions, ultrasonography is frequently utilised as the first investigative modality.
Objective :To assess the diagnostic accuracy of ultrasonography in distinguishing benign and malignant thyroid nodules by correlating sonographic findings with pathological diagnosis as a reference..
Method: From June 2020 to  December 2021, a prospective study was conducted on 100 patients who visited the  Apollo medical college and District head quarters hospital,              in the OPD of the department of radio diagnostics. All patients with thyroid swelling, mass, or enlargement were examined with  USG before undergoing FNAC.
Results: Of the 120 Thyroid disease patients in my study, 77 percent were females and 23 percent were males. The patients with the highest number of instances were between the ages of 41 and 50, accounting for 37 percent of all cases. 'Lump in the neck' was the most common complaint. Euthyroidism was the most common diagnosis (73). Solitary Thyroid Nodule was the most prevalent disease found on thyroid sonography (42percent ). The diagnostic accuracy of high resolution sonography in thyroid disorders was 84 percent Sensitivity and 96 percent Specificity.
Conclusion: Many malignant or potentially malignant thyroid nodules can be detected with ultrasonography. Although there is some overlap in the appearance of benign and malignant nodules on ultrasonography, some ultrasonography features can aid distinguish between the two. Even though it can report malignancy of the follicular variety, FNAC can diagnose benign disorders and can also be used as a supplement to ultrasonography features to signal malignancy.

A Retrospective assessment of the histo-morphological diversity of various lesions of the uterus, cervix and adnexa

Dr. Vani H Patel, Dr. Maulik K Mehariya, Dr. Vishal S Patel

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 90-95

Aim: To study the histo-morphological diversity of various lesions of the uterus, cervix and adnexa.
Materials and Methods: A Retrospective Histopathological study of 609 cases of nonneoplastic and neoplastic lesions of hysterectomy specimens was conducted in Department of Pathology, over the period from June 2015- May 2017. Hysterectomy specimen with or without unilateral or bilateral adnexa received in the department. The specimens were analyzed in detail macroscopically for various parameters like size, external surface, and consistency and cut sections.
Results: Atrophic changes were seen in 13.46% cases. Endometrial hyperplasia was seen in 26 cases. Among the neoplastic lesions 2.46% cases were endometrial polyps with only 3 cases of malignancy forming 0.49%. Among the histologic types of lesions of myometrium, majority were Leiomyoma (27.59%). Leiomyoma and Adenomyosis were seen in 55 cases (9.04%). Adenomyosis was seen in 22.00%. Chronic cervicitis was seen in 36.07% cases and chronic cystic cervicitis in 6.21% of cases. Nabothian cyst were seen in 124 cases (20.80%). 19.80% cases showed Squamous metaplasia. Out of 188 Ovarian lesions, 167 (88.83%) were non-neoplastic lesions and 21 (11.17%) were neoplastic lesions. Fallopian tube pathology included chronic salpingitis in 2 cases, paratubal cyst in 07 cases. 69.4% of cases show unremarkable fallopian tubes.
Conclusion: The present study provides awareness into the wide range of histopathological patterns of lesions in uterus and cervix in hysterectomy specimens. It aids to appropriate management in the postoperative period.

Comparative Study of Laparoscopic Assisted Vaginal Hysterectomy Versus Total Abdominal Hysterectomy in Benign Gynecological Conditions

Dr. Mortha Sulochana, Dr. Sharda Rakesh Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 965-972

INTRODUCTION: The term “hysterectomy” though means removal of uterus, in practice it
has a much wider classification depending upon the indication. At times, it is done without
removal of cervix (supracervical hysterectomy) or with removal of adnexa (hysterectomy
with salpingooopherectomy). It can also be a part of staging laparotomy or radical
hysterectomy. Hysterectomy can be performed abdominally, vaginally or through abdominal
ports with the help of laparoscope.

TO DETERMINE THE EFFICACY OF ULTRASOUND IN THE DIAGNOSIS OF NECK SWELLINGS

Dr SeemaPandey, Dr Neetu Singh, Dr Mahendra Mehta, Dr Sunil Sanga

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 1264-1271

Aim: To determine the efficacy of ultrasound in the diagnosis of neckswellings.
Methods: This research comprised 50 instances with clinically evident swellings in the neck area. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ultrasonography diagnosis were assessed for each group of neck swellings. The sensitivity analysis for such a tiny number is invalid since there were only three congenital swellings.
Results: Our research comprised patients of various ages, with a minimum age of 25 days and a maximum age of 82 years, with a mean age of 37.5 years. In our research, 15 (30%) of the patients were men, whereas 35 (70%) were girls.  According to the research, about two-thirds (32) of neck swellings were solid, 5 were cystic, and 13 swellings contained both solid and cystic components. In our investigation, 64% of clinically firm swellings were determined to be solid, whereas the rest were either completely cystic or mixed in nature. This research found that the Sensitivity, Specificity, PPV, and NPV of the US for inflammatory swellings are 87 percent, 97 percent, 95 percent, and 92 percent, respectively. The sensitivity analysis of clinical diagnosis and ultrasound diagnostic for inflammatory swellings.The sensitivity of US in identifying malignant lesions of the neck in 50 patients with neck swellings was 87 percent in this research, with a specificity of 99 percent, PPV 93 percent, and NPV 97 percent.
Conclusion: US can tell the difference between solid and cystic neck swellings, as well as malignant and benign neck swellings. It may detect thyroid, salivary gland, and lymph node lesions, as well as differentiate between abscess and cellulitis.

A HOSPITAL BASED OBSERVATIONAL STUDY TO CORRELATE THE CYTOLOGICAL FEATURES OF THE ASCITIC FLUID WITH CLINICAL DATA AT NEWLY ESTABLISHED TERTIARY CARE CENTER: A CLINICO-PATHOLOGICAL STUDY

Anil Kumar Sethiya, Madan Kumar Solanki, Hanuman Ram Choudhary

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 1696-1705

Background: The proper evaluation of ascitic fluid helps in narrowing the diagnostic dilemma faced by the physicians and helps in better management of the patients. Early and accurate diagnosis often depends on appropriate ascitic fluid analysis. The aim of this study to correlate the cytological features of the ascitic fluid with clinical data at newly established tertiary care center.
Materials & Methods: A prospective study was conducted in the Department of Pathology, in a tertiary health care centre over a period of one year. Cytological examination was performed to reveal important information regarding the causes of ascites and classified as benign (with or without infection/ spontaneous bacterial peritonitis), suspicious or malignant conditions. Cytomorphology of the cells was studied and documented paying attention to cellular arrangement, cytoplasmic features and nuclear characteristics. Clinical information of the patient and cytomorphological features of the smears were studied and the samples were categorized into benign (with or without infection/ SBP), suspicious of malignancy or malignant.
Results: Our study showed that the mean age was 55.67 years. Out of 30 cases, 14 were males and 16 were females, with male to female ratio being 7:8. Out of 30 samples, 26 (86.66%) were benign, 2 (6.66%) were suspicious of malignancy, and 2 (6.66%) were positive for malignancy. The most frequent clinical diagnosis was Alcoholic Liver disease comprising of 8 (26.66%) cases. The predominant cell type was Lymphocyte in 14 (46.66%) of cases, Neutrophil in 9 (30%) of cases, Reactive mesothelial cell in 5 (16.66%) of cases and atypical/malignant cells in 2 (6.66%) of cases. Histiocytic cells were also seen.
Conclusion: We concluded that non neoplastic and neoplastic conditions causing ascites can be diagnosed on ascitic fluid cytology. Increased neutrophil count is strongly suggestive of spontaneous bacterial peritonitis (SBP). The careful cytomorphological examination of ascitic fluid is a valuable, simple, rapid, inexpensive and reliable technique in the differential diagnosis of ascites, particularly in resource limited settings.

Assessment of total PSA and free PSA levels in female patients with breast cancer

Dr. Ruhi Mahajan, Dr. Rishabh Gupta, Dr. Servishet Saraf, Dr. Jharna Verma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 976-980

Background:Breast cancer continues to be a significant health threat, being the second
most common cancer among Indian women. The present study was conducted to assess
total PSA and free PSA levels in female patients with breast cancer.
Materials & Methods: female patients with tumours growth of breast were included.
Patients were classified into benign and malignant growth according to WHO
classification. Patients were classified into group I (breast growth) and healthy subjects
were put in group II. Parameters such as serum total prostate specific antigen (TPSA),
serum free prostate specific antigen (FPSA) was recorded.
Results: Age group 20-40 years had 30 in group I and 28 in group II and 40-60 years
had 35 in group I and 37 in group II. There were 38 benign and 27 malignant lesions of
breast. The difference was significant (P< 0.05). The mean total PSA in benign lesions
was 12.2, in malignant was 15.7 and in group II was 1.8 and free PSA was 0.15 in
benign, 0.22 in malignant and 2 in group II. The difference was significant (P< 0.05).
Conclusion: Both benign and malignant breast tumour patients exhibited high level of
free and total prostate specific antigen.

A study of ovarian lesions among various age group and to correlate them with the clinical features

Abhilash NP, Vanisri HR, Mudassar Ahmed Shariff, Raghavendra D

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2270-2276

Background: Tumours of the ovary are common forms of neoplasms in women. The pathology of ovarian neoplasms is one of the most complex areas of gynaecology, because the ovary gives rise to the greater and larger variety of tumours than any other organ. While in other organs, tissue of origin is usually clear, tissue from which an ovarian tumour arises is often uncertain and most of the development of the presumptive tissue is often in disparity.
Objectives: To determine the nature of ovarian masses presented to Department of Pathology, CIMS during the last 2 years.
Methodology: The present retrospective record based observational study was conducted by the department of Pathology from March 2022 to May 2022 from the data of the patients from the records from January 2019 to December 2021. All the specimen obtained in the Department of Pathology for Histopathological examination during the study period from the patients diagnosed with ovarian lesion in the hospital were included for the study.
Results: In the present study majority (29%) of them belonged to 30 to 40 years of age, 23% of them were aged less than 20 years. In the present study 65% of them complained of Mass per abdomen, 40% of them had pain in abdomen, 10% had ascites, 9% had menstrual irregularities, 5% had infertility related issues and 5% of them were asymptomatic in nature. The highest incidence of Benign tumor was seen in the age group of 30 to 40 years (32.5%), in the age group of less than 20 years it was 25.9%. The Malignant tumor was found to be more common those aged more than 40 years with 26% of them in 40 to 50 years of age, 21.7% of them in 50 to 60 years of age.
Conclusion: In conclusion, a variety of clinical factors, including the patient's age, presenting symptoms, the location and size of the lump and the histological type of the ovarian tumour, are all connected. All of these clinical and histomorphological characteristics, as well as cutting-edge, more modern diagnostic techniques like immunohistochemistry and morphometric analysis, can aid in early diagnosis, the planning of a course of therapy and prognostic information.

A Prospective hospital based observational assessment of patient with ovarian malignancies

Dr. Deepak Thakker, Dr. Shailendra V Mangnale

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2127-2133

Aim: To analyze the clinical presentation and histopathological types of ovarian malignancies.
Material and methods: A Prospective hospital based observational study was conducted in the Department of Obstetrics and Gynaecology at VIMS, Dahanu for the period of 1.5 years. Total 100 cases of ovarian tumours were included in this study. The tumours were cut and allowed to fix in 10% formalin for 24-48 hours. After formalin fixation, multiple bits were taken for histopathological examination. The blocks were cut at 3-5 microns thickness and stained with Haematoxylin and Eosin. Detailed microscopic examination of the tumour was done.
Results: Out of 100 cases of ovarian tumours, 71 were benign, 6 were tumours of low malignant potential and 23 were malignant. The youngest patient was 12 months and the oldest was 67 years forming a range of 18 months to 67 years. Highest incidence of ovarian tumour was noted in the 40-50years 38cases out of 100 cases accounting for 38%. Highest incidence of benign ovarian tumour was noted in 30-40 years 26 cases out of 71 accounting for 36.62%. Highest incidence of malignant tumour was noted in the 40-50years 12 out of 23 cases accounting for 52.17%. 37% of the patients complained of dull aching lower abdominal pain, 24% complained of abdominal mass and 6% of the patients gave history of menstrual disturbance like menorrhagia. Urinary disturbances were found in 5% patients with tumours. Out of 100 patients 9 patients were not married and all were below twenty years of age. Among married, 83were parous and remaining were 8 nulliparous. Out of 100 cases of ovarian tumors, 29 were associated with appendicitis and 14 were associated with uterovaginal prolapse.
Conclusion: The ovarian tumors manifest a complex and varied spectrum of clinical, morphological and pathological features. Correlating the clinical parameters and categorizing the tumors according to the WHO classification help us in coming to an early diagnosis, management and hence in the prognosis of ovarian tumors.

Comparative assessment of the ultrasonography (USG) and computed tomography (CT) in the evaluation of suspicious ovarian masses

Dr. Yashaswi Sharma, Dr. Anchal Sharma, Dr. Nikhil Arora, Dr. Ashna Agarwal, Dr. Aditya Kaul, Dr. Naresh Tripathi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 1108-1112

Aim: To compare modalities like ultrasonography (USG) and computed tomography (CT) in
the evaluation of suspicious ovarian masses.
Methodology: This prospective comparative study was carried out in the Department of
Radiology, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan,
Himachal Pradesh for a period of 12 months. Total 50 women were included in this
prospective study. All patients underwent abdominal Ultrasonography and CT scan with
determination of the ovarian mass characteristics. Detailed history of allergy and renal
function tests were taken before doing CT scan and if there was history of allergy then nonionic
contrast was used. Site, size, papillary projections, wall characteristics, capsular
infiltrations, the presence of solid areas inside the mass and presence of as cites were
recorded both by US and CT scan.
Results: Out of 50 patients, majority of patients belonged to 40-50 years of age group (19,
38%) followed by 30-40 years of age group (10, 20%). 8 patients (16%) belonged to 20-30
years age group, 7 (14%) belonged to 50-60 years, 60 years of age group included 3
patients each. There are total 29 cases of Pre-menopausal stage and 21 cases of Postmenopausal
stage having ovarian cyst. Out of 29 cases of Pre-menopausal conditions have 7
number of malignant and 22 number of benign type of ovarian masses. In the Postmenopausal
group there are 17 cases of malignant and 4 cases of benign ovarian mass was observed.
Overall, CT was found to have 96% sensitivity, 92% specificity, and an accuracy of 92% in
the differentiation of benign and malignant ovarian masses, while PPV and NPV were 94%
and 90%, respectively. The sensitivity of USG was 90%, specificity was 86% and PPV and
NPV were 88% and 86% respectively.
Conclusion: CT and USG imaging all have approximately similar accuracy in staging
ovarian carcinoma but the sensitivity of CT scan for all ovarian cancer detection greater than
that of US. Among women with ovarian disorders, CT can be primarily in patients with
ovarian malignancies, either to assess disease extent prior to surgery or as a substitute for
second look laparotomy.

Transthoracic needle aspiration biopsy of benign and malignant lung lesions

Dr. Kumari Sunita Bharati, Dr. Rashmi Rani Bharti, Dr. Richa Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 1427-1462

Background: The purpose of the present study is to evaluate the accuracy of TNAB for the
diagnosis of benign and malignant lung lesions.
Methods: The present study included 50 patients from June 2020 to June 2021. Our
retrograde study on CT- guided or ultrasound guided lung biopsy on tertiary care center of
Bihar Indira Gandhi Institute of Medical Science.
Results: Out of malignant lesions, most were adenocarcinoma 71.87% followed by
squamous cell carcinoma 15.63%, poorly differentiated carcinoma 9.38% and non-hodgkins
lymphoma 3.12%. In the benign lesions, most of the cases were non-specific inflammatory
lesion 44.45% followed by granulomatous lesion 27.78%, A-V malformation 11.12%,
neurofibroma 5.55%, spindle cell lesion 5.55% and necrosis 5.55%.
Conclusion: The ability to diagnose only malignant lesions by TNAB would markedly limit
the efficacy of that technique, since surgery would be performed on most malignant lesions
diagnosed by TNAB as well as on the lesions not diagnosed by TNAB.

Skin Cancer Detection Using VGG-16

Kanneboina Manasa; Dr.G.Vishnu Murthy

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 1, Pages 1419-1426

Skin cancer is a dangerous disease. Benign and malignant melanomas are one of the skin cancer diseases. Melanoma is a highly dangerous disease. It can be curable if it is detected early. Benign can be cured easily but malignant cannot be cured fastly. Benign and malignant melanoma appears in the  early stages while differentiating them. Different methods have been used for differentiating them. Skin cancer can be detected in early stages by visualizing with clinical screening by dermoscopic analysis. Detecting automatically skin lesion is a typical task. Skin cancer symptoms are small blood vessels visible, thickened patch, ulcers and bleed. Skin cancer detected by capturing images with a skin magnifier with polarized light and diagnosed with deep learning classifier in which data augmentation and weights can be added to it. In this CNN classifier is used in which RESNET-50 and VGG-16 were used in which image were resized and weights were added and then the augmentation of the data can be done.

Evaluation of Spectrum of Neck Masses on MDCT and Tissue Diagnosis Correlation

Shaina Kaur; Anisha Galhotra; Arnav Galhotra; Ritu Dhawan; Kamini Gupta; Parambir Sandhu; Kavita Saggar

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 8316-8327

INTRODUCTION: The neck is a part of the body that has many vital structures in a relatively small region with complex anatomy. Various pathologies of the neck may present as neck swellings. The mass may be first noticed by the patient, other individual or by the physician as an incidental finding during physical examination. With the improvement of CT imaging techniques, shorter examination time, higher resolution imaging, Multidetector CT is particularly useful in evaluation of neck masses. AIM OF STUDY: To assess the role of MDCT in neck masses for characterization of nature of lesion (benign or malignant) and organ of origin and to Correlate with tissue diagnosis wherever possible. MATERIALS AND METHODS: Patients presenting with clinical suspicion of neck masses and referred for MDCT neck to the Department of Radio-diagnosis and Imaging, DMCH, Ludhiana were included in this study. RESULTS: 18.9% patients were in 31-40 years age group. Mean age for malignant lesions was 58.3 years. Most common space involved was visceral space (48.9%) and the most common diagnosis was benign thyroid nodule(s) (30%). Many of malignant lesions showed ill-defined margins (68.18%), necrosis (62.5%), heterogeneous enhancement (68.2%), bony infiltration (20.8%), obliteration of fat planes (8.3%), metastasis (45.8%), involvement of adjacent neck spaces (37.5%), vascular involvement in form of internal jugular vein thrombosis (8.3%) of cases. In diagnosing malignant lesions, CT had a sensitivity of 95.83%, specificity of 96.30%, positive predictive value of 92.00%, negative predictive value of 98.11% and accuracy of 96.15%. CONCLUSION: MDCT has high accuracy for characterization of a lesion as benign or malignant. It provides the best possible contrast of soft tissue (with the choice of appropriate delay, contrast agent volume, flow rate and scanning time), visualization of vascular structures, extent of lesion, bone and airway details, thus helps in making diagnosis and deciding further course of management.